Provider Demographics
NPI:1184071433
Name:OB-GYN EXPRESS MEDICAL SERVICES, PLLC
Entity type:Organization
Organization Name:OB-GYN EXPRESS MEDICAL SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:UME
Authorized Official - Middle Name:
Authorized Official - Last Name:FARWA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-203-4444
Mailing Address - Street 1:705 S WILLIAM ST
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:12095-3212
Mailing Address - Country:US
Mailing Address - Phone:518-844-6243
Mailing Address - Fax:
Practice Address - Street 1:7062 KISSENA BLVD FL 2
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367-2245
Practice Address - Country:US
Practice Address - Phone:518-844-6243
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-17
Last Update Date:2016-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty