Provider Demographics
NPI:1205074960
Name:URBAN MEDICAL CENTER, INC.
Entity type:Organization
Organization Name:URBAN MEDICAL CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HYACINTH
Authorized Official - Middle Name:EMENIKE
Authorized Official - Last Name:UCHEAGWU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-469-6659
Mailing Address - Street 1:129 JEWETT AVE
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07304-2003
Mailing Address - Country:US
Mailing Address - Phone:201-469-6659
Mailing Address - Fax:
Practice Address - Street 1:95 MARTIN LUTHER KING JR DR
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07305-3025
Practice Address - Country:US
Practice Address - Phone:201-469-6659
Practice Address - Fax:201-332-7003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-03
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI017834001223G0001X
NJ25MA08302800208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty