Providence Medical Services PLLC
Clinic/Center, Urgent Care in Mount Vernon, NY. Organization (NPI-2).
NPI number1417452467
StatusActive
Last updated in NPPESMar 29, 2018
Details
- NPI
- 1417452467
- Entity type
- Organization (NPI-2)
- Legal business name
- Providence Medical Services PLLC
- Organization subpart
- No
- Enumeration date
- Mar 29, 2018
- Last updated
- Mar 29, 2018
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QU0200X | Clinic/Center, Urgent Care | 287577 | NY | Yes |
Other names
- Afc Urgent Care Mount Vernon (Doing Business As)
Practice location
203 Gramatan AveMount Vernon, NY 10550-1291
Phone 860-212-9306
Mailing address
121 Poverty Hollow RdNewtown, CT 06470-1800
Phone 860-212-9306
Authorized official
Dharini Sun
Medical Director
8602129306
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