Provider Demographics
NPI:1760659015
Name:EXPRESS PEDIATRICS: WALK IN URGENT CARE FOR CHILDREN, PLLC
Entity Type:Organization
Organization Name:EXPRESS PEDIATRICS: WALK IN URGENT CARE FOR CHILDREN, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MIRANDA
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:914-393-7156
Mailing Address - Street 1:1989 ROUTE 52
Mailing Address - Street 2:SUITE 3
Mailing Address - City:HOPEWELL JUNCTION
Mailing Address - State:NY
Mailing Address - Zip Code:12533-3533
Mailing Address - Country:US
Mailing Address - Phone:845-897-4500
Mailing Address - Fax:845-897-4550
Practice Address - Street 1:1989 ROUTE 52
Practice Address - Street 2:SUITE 3
Practice Address - City:HOPEWELL JUNCTION
Practice Address - State:NY
Practice Address - Zip Code:12533-3533
Practice Address - Country:US
Practice Address - Phone:845-897-4500
Practice Address - Fax:845-897-4550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-14
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY210185261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care