CITY MEDICAL OF UPPER EAST SIDE PLLC NPI 1548889736

NPI Information

CITY MEDICAL OF UPPER EAST SIDE, PLLC is an urgent care clinic center in Queens Village, NY. CITY MEDICAL OF UPPER EAST SIDE, PLLC NPI is 1548889736. The provider is registered as an organization entity type.

The provider's business location address is:

22405 JAMAICA AVE
QUEENS VILLAGE, NY
ZIP 11428-019
Phone: (718) 571-9395
Fax: (718) 571-9413

The provider's authorized official is Marlena Simpson .
The authorized official title is Vp, Credentialing & Enrollment and has the following contact phone number (516) 453-0435.

The CLIA number assigned to this NPI record is 33D2219721 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/9/2020 and was last updated on 4/9/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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