Provider Demographics
NPI:1437738507
Name:RALPH AVE URGENT CARE
Entity Type:Organization
Organization Name:RALPH AVE URGENT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:
Authorized Official - Last Name:KORNBLIT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-376-2453
Mailing Address - Street 1:3209 MILBURN AVE
Mailing Address - Street 2:
Mailing Address - City:BALDWIN
Mailing Address - State:NY
Mailing Address - Zip Code:11510
Mailing Address - Country:US
Mailing Address - Phone:516-867-6868
Mailing Address - Fax:516-623-4600
Practice Address - Street 1:1647 RALPH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11236
Practice Address - Country:US
Practice Address - Phone:718-682-3888
Practice Address - Fax:516-623-4600
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KORNBLIT MEDICAL PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-04-06
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical ServicesGroup - Single Specialty