Provider Demographics
NPI:1336173194
Name:UPTOWN HEALTHCARE MANAGEMENT INC.
Entity Type:Organization
Organization Name:UPTOWN HEALTHCARE MANAGEMENT INC.
Other - Org Name:EAST TREMONT MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:DR. H
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-764-1661
Mailing Address - Street 1:930 EAST TREMONT AVENUE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10460-4304
Mailing Address - Country:US
Mailing Address - Phone:718-764-1633
Mailing Address - Fax:646-224-1320
Practice Address - Street 1:930 EAST TREMONT AVENUE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10460
Practice Address - Country:US
Practice Address - Phone:718-764-1661
Practice Address - Fax:646-224-1320
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UPTOWN HEALTHCARE MANAGEMENT INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-10
Last Update Date:2017-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY086172207N00000X
207R00000X, 207RE0101X, 207RG0100X, 207V00000X, 207W00000X, 208600000X, 208800000X, 213E00000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
No208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01672999Medicaid
NYB10482Medicare UPIN
NY3K0141Medicare PIN
NYW6L912Medicare ID - Type Unspecified