Provider Demographics
NPI:1659879088
Name:COLOMBUS URGENT CARE PC
Entity Type:Organization
Organization Name:COLOMBUS URGENT CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PRANAY
Authorized Official - Middle Name:J
Authorized Official - Last Name:BHATT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-688-4424
Mailing Address - Street 1:350 BLOOMFIELD AVE STE 4
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-4852
Mailing Address - Country:US
Mailing Address - Phone:973-748-9330
Mailing Address - Fax:973-748-6985
Practice Address - Street 1:3235 JOHN F KENNEDY BLVD
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-3405
Practice Address - Country:US
Practice Address - Phone:908-688-4424
Practice Address - Fax:973-748-6985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-31
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
01118975OtherAMERIGROUP