1154663110 NPI number — IMMEDIATE MEDICAL HEALTH CARE PLLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154663110 NPI number — IMMEDIATE MEDICAL HEALTH CARE PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
IMMEDIATE MEDICAL HEALTH CARE PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
NYD PRIMARY & PULMONARY CARE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1154663110
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/21/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
484 TEMPLE HILL RD
Provider Second Line Business Mailing Address:
SUITE 104
Provider Business Mailing Address City Name:
NEW WINDSOR
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
12553-5557
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
845-565-3700
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
205 LEXINGTON AVE
Provider Second Line Business Practice Location Address:
SUITE101
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10016-6022
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-684-4700
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/18/2013

Additional Information

Authorized Official

Authorized Official Last Name:
RUVO
Authorized Official First Name:
ANTHONY
Authorized Official Middle Name:
R
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
212-734-6621

Provider Taxonomy Codes

  • Taxonomy code: 207RP1001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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