1225395320 NPI number — WHITE PLAINS WALK-IN MEDICAL CARE PLLC

Table of content: (NPI 1225395320)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225395320 NPI number — WHITE PLAINS WALK-IN MEDICAL CARE PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WHITE PLAINS WALK-IN MEDICAL 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:
Provider Other Organization Name Type Code:
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:
1225395320
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/31/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
13 MOHAWK TRL
Provider Second Line Business Mailing Address:
WHITE PLAINS WALK-IN MEDICAL CARE, PLLC
Provider Business Mailing Address City Name:
KATONAH
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10536-2908
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
914-260-9235
Provider Business Mailing Address Fax Number:
914-767-9200

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10 CHESTER AVE
Provider Second Line Business Practice Location Address:
WHITE PLAINS WALK-IN MEDICAL CARE, PLLC
Provider Business Practice Location Address City Name:
WHITE PLAINS
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10601-5112
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-260-9235
Provider Business Practice Location Address Fax Number:
914-767-9200
Provider Enumeration Date:
04/13/2012

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
GOYAL
Authorized Official First Name:
SHIKHA
Authorized Official Middle Name:
Authorized Official Title or Position:
PROPRIETOR
Authorized Official Telephone Number:
914-260-9235

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  203434 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QU0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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