Provider Demographics
NPI:1033459094
Name:FAMILY URGENT CARE CLINIC, PLLC
Entity Type:Organization
Organization Name:FAMILY URGENT CARE CLINIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TAX MATTERS MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAJAA
Authorized Official - Middle Name:
Authorized Official - Last Name:NEBBARI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:570-780-4552
Mailing Address - Street 1:1831 PITTSTON AVE
Mailing Address - Street 2:LEFT BUILDING
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18505-1651
Mailing Address - Country:US
Mailing Address - Phone:570-507-9517
Mailing Address - Fax:570-507-9520
Practice Address - Street 1:1831 PITTSTON AVE
Practice Address - Street 2:LEFT BUILDING
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18505-1651
Practice Address - Country:US
Practice Address - Phone:570-507-9517
Practice Address - Fax:570-507-9520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-27
Last Update Date:2015-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty