Organization · NPI-2
96th Street Urgent Care
Family Medicine · Stone Harbor, NJ
NPI number1235359001
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1235359001
- Entity type
- Organization (NPI-2)
- Legal business name
- 96th Street Urgent Care
- Organization subpart
- No
- Enumeration date
- Apr 26, 2007
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | mb72117 | NJ | Yes |
Other names
- 96th Street Urgent Care (Doing Business As)
Practice location
376 96th StSuite # 2
Stone Harbor, NJ 08247-1404
Phone 609-368-3500 · Fax 609-967-0077
Mailing address
376 96th StSuite # 2
Stone Harbor, NJ 08247-1404
Phone 609-368-3500 · Fax 609-967-0077
Authorized official
Tara A Vogdes
Owner
6099670070
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