Provider Demographics
NPI:1497576946
Name:URBANE CARE NP, NURSE PRACTITIONER IN FAMILY HEALTH, PLLC.
Entity type:Organization
Organization Name:URBANE CARE NP, NURSE PRACTITIONER IN FAMILY HEALTH, PLLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY HEALTH NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:OMOTARA
Authorized Official - Middle Name:
Authorized Official - Last Name:ADEWALE
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, NP-C, FNP-BC
Authorized Official - Phone:646-465-4656
Mailing Address - Street 1:42 AMITY PL
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10303-1713
Mailing Address - Country:US
Mailing Address - Phone:929-367-0510
Mailing Address - Fax:929-367-0511
Practice Address - Street 1:420 SOUTH AVENUE
Practice Address - Street 2:2ND FLOOR, EX SUITES, SUITE 125
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10303
Practice Address - Country:US
Practice Address - Phone:929-367-0510
Practice Address - Fax:929-367-0511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-17
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Multi-Specialty
No2083B0002XAllopathic & Osteopathic PhysiciansPreventive MedicineObesity MedicineGroup - Multi-Specialty
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty