Provider Demographics
NPI:1154684207
Name:THROGS NECK URGENT MEDICAL CARE PLLC
Entity Type:Organization
Organization Name:THROGS NECK URGENT MEDICAL CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:R
Authorized Official - Last Name:RUVO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-565-3700
Mailing Address - Street 1:484 TEMPLE HILL RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:NEW WINDSOR
Mailing Address - State:NY
Mailing Address - Zip Code:12553-5557
Mailing Address - Country:US
Mailing Address - Phone:845-565-9400
Mailing Address - Fax:
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:718-684-3939
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-22
Last Update Date:2014-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03828008Medicaid
NY03828008Medicaid