Provider Demographics
NPI:1609422633
Name:TUXEDO PARK URGENT CARE PLLC
Entity Type:Organization
Organization Name:TUXEDO PARK URGENT CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:M
Authorized Official - Last Name:BAQUIRAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-923-7454
Mailing Address - Street 1:549 NY-17
Mailing Address - Street 2:SUITE F
Mailing Address - City:TUXEDO
Mailing Address - State:NY
Mailing Address - Zip Code:10987
Mailing Address - Country:US
Mailing Address - Phone:201-923-7454
Mailing Address - Fax:
Practice Address - Street 1:549 NY-17
Practice Address - Street 2:SUITE F
Practice Address - City:TUXEDO
Practice Address - State:NY
Practice Address - Zip Code:10987
Practice Address - Country:US
Practice Address - Phone:201-923-7454
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-15
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care