Provider Demographics
NPI:1336426667
Name:STATCARE URGENT & WALK IN MEDICAL CARE PLLC
Entity Type:Organization
Organization Name:STATCARE URGENT & WALK IN MEDICAL CARE PLLC
Other - Org Name:NAO MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:PRITI
Authorized Official - Middle Name:
Authorized Official - Last Name:JAIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-938-1550
Mailing Address - Street 1:17 E OLD COUNTRY RD
Mailing Address - Street 2:UNIT B
Mailing Address - City:HICKSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11801-4270
Mailing Address - Country:US
Mailing Address - Phone:516-938-1550
Mailing Address - Fax:
Practice Address - Street 1:3715 23RD AVE
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11105-1993
Practice Address - Country:US
Practice Address - Phone:516-938-1550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-15
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG10006804OtherMEDICARE PTAN