Provider Demographics
NPI:1134137573
Name:THROGGS NECK WALK IN MEDICAL CARE
Entity Type:Organization
Organization Name:THROGGS NECK WALK IN MEDICAL CARE
Other - Org Name:EAST TREMONT URGENT MEDICAL CARE
Other - Org Type:Other Name
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SANDEEP
Authorized Official - Middle Name:
Authorized Official - Last Name:GUPTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-597-5800
Mailing Address - Street 1:PO BOX 1012
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10465-1012
Mailing Address - Country:US
Mailing Address - Phone:718-597-5800
Mailing Address - Fax:718-829-4118
Practice Address - Street 1:3594 E TREMONT AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10465-2032
Practice Address - Country:US
Practice Address - Phone:718-597-5800
Practice Address - Fax:718-829-4118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY212451305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWER581Medicare ID - Type Unspecified