Provider Demographics
NPI:1265942403
Name:UBYLEE HEALTHCARE GROUP, PLLC
Entity type:Organization
Organization Name:UBYLEE HEALTHCARE GROUP, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BAPTISTE
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:MARINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:800-984-7279
Mailing Address - Street 1:PO BOX 1707
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28106-1707
Mailing Address - Country:US
Mailing Address - Phone:800-984-7279
Mailing Address - Fax:980-262-3528
Practice Address - Street 1:9723 NORTHEAST PKWY
Practice Address - Street 2:STE 100
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-9719
Practice Address - Country:US
Practice Address - Phone:980-262-3007
Practice Address - Fax:980-262-3528
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-02
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207Q00000X, 174400000X, 261Q00000X
NJ1316276694225X00000X
NC1104070820261QX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
No261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1316276694OtherNPPES
NC1326112616OtherNPPES