Provider Demographics
NPI:1649884263
Name:URBAN FAMILY PRACTICE PC
Entity type:Organization
Organization Name:URBAN FAMILY PRACTICE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING PROJECT MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:EVA
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-445-1932
Mailing Address - Street 1:564 NIAGARA ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14201-1108
Mailing Address - Country:US
Mailing Address - Phone:716-882-0366
Mailing Address - Fax:716-884-8096
Practice Address - Street 1:564 NIAGARA ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14201-1108
Practice Address - Country:US
Practice Address - Phone:716-882-0366
Practice Address - Fax:716-884-8096
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:URBAN FAMILY PRACTICE, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-09-01
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care