Provider Demographics
NPI:1669644837
Name:UPTOWN HEALTHCARE MANAGEMENT, INC.
Entity Type:Organization
Organization Name:UPTOWN HEALTHCARE MANAGEMENT, INC.
Other - Org Name:AMBULATORY SURGERY CENTER OF EAST TREMONT MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:HISHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-764-1661
Mailing Address - Street 1:930 E TREMONT AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10460-4304
Mailing Address - Country:US
Mailing Address - Phone:718-764-1633
Mailing Address - Fax:646-224-1320
Practice Address - Street 1:930 E TREMONT AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10460-4304
Practice Address - Country:US
Practice Address - Phone:718-764-1633
Practice Address - Fax:646-224-1320
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EAST TREMONT MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-03-28
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01672999Medicaid
NY01672999Medicaid