Basic Information
Provider Information
NPI: 1013278274
EntityType: 2
ReplacementNPI:  
OrganizationName: MIDTOWN NEW YORK DOCTORS URGENT CARE PLLC
LastName:  
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Mailing Information
Address1: 484 TEMPLE HILL RD
Address2: SUITE 104
City: NEW WINDSOR
State: NY
PostalCode: 125535557
CountryCode: US
TelephoneNumber: 8455659400
FaxNumber: 8455653696
Practice Location
Address1: 205 LEXINGTON AVE
Address2: SUITE 101
City: NEW YORK
State: NY
PostalCode: 100166022
CountryCode: US
TelephoneNumber: 2126844700
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/05/2012
LastUpdateDate: 07/03/2014
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: RUVO
AuthorizedOfficialFirstName: ANTHONY
AuthorizedOfficialMiddleName: R
AuthorizedOfficialTitleorPosition: MANAGER
AuthorizedOfficialTelephone: 8455653700
IsSoleProprietor:  
IsOrganizationSubpart: N
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AuthorizedOfficialCredential: MD
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
261QU0200X  Y Ambulatory Health Care FacilitiesClinic/CenterUrgent Care

No ID Information.


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