Provider Demographics
NPI:1952562084
Name:URBAN, MICHAEL J (RN)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:J
Last Name:URBAN
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:446 BROAD STREET
Mailing Address - Street 2:
Mailing Address - City:ONEIDA
Mailing Address - State:NY
Mailing Address - Zip Code:13421
Mailing Address - Country:US
Mailing Address - Phone:315-264-3365
Mailing Address - Fax:240-209-8897
Practice Address - Street 1:446 BROAD ST
Practice Address - Street 2:
Practice Address - City:ONEIDA
Practice Address - State:NY
Practice Address - Zip Code:13421-2449
Practice Address - Country:US
Practice Address - Phone:315-264-3365
Practice Address - Fax:240-209-8897
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-20
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY6163047163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse