Provider Demographics
NPI:1205368172
Name:NIAGARA FALLS URGENT CARE
Entity Type:Organization
Organization Name:NIAGARA FALLS URGENT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SANTANU
Authorized Official - Middle Name:
Authorized Official - Last Name:SOM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-661-5621
Mailing Address - Street 1:3117 MILITARY RD
Mailing Address - Street 2:
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14304-4813
Mailing Address - Country:US
Mailing Address - Phone:716-297-2052
Mailing Address - Fax:716-215-6170
Practice Address - Street 1:3117 MILITARY RD STE 2
Practice Address - Street 2:
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14304-4813
Practice Address - Country:US
Practice Address - Phone:716-297-2052
Practice Address - Fax:855-409-5577
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOM MEDICAL PRACTICE PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-03-30
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QM0801X, 261QP2300X
NY242962261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care