Provider Demographics
NPI:1184047870
Name:LI URGENT CARE PC
Entity type:Organization
Organization Name:LI URGENT CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN /OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MELINA
Authorized Official - Middle Name:JOSEPHINE
Authorized Official - Last Name:KHWAJA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-582-1441
Mailing Address - Street 1:9 BRIAR CT
Mailing Address - Street 2:
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-2010
Mailing Address - Country:US
Mailing Address - Phone:516-582-1441
Mailing Address - Fax:
Practice Address - Street 1:403 LITTLE EAST NECK RD
Practice Address - Street 2:
Practice Address - City:WEST BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11704-6518
Practice Address - Country:US
Practice Address - Phone:631-716-5463
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-30
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY226774207P00000X
261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty