Provider Demographics
NPI:1770885808
Name:URGENT CARE PHYSICIAN OF NEW YORK-HARTSDALE PLLC
Entity type:Organization
Organization Name:URGENT CARE PHYSICIAN OF NEW YORK-HARTSDALE PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:VICKI
Authorized Official - Middle Name:
Authorized Official - Last Name:PURUGGANAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-426-7665
Mailing Address - Street 1:843 HUTCHINSON RIVER PKWY
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10465-1818
Mailing Address - Country:US
Mailing Address - Phone:718-925-4400
Mailing Address - Fax:718-684-1310
Practice Address - Street 1:843 HUTCHINSON RIVER PKWY
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10465-1818
Practice Address - Country:US
Practice Address - Phone:718-925-4400
Practice Address - Fax:718-684-1310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-22
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care