CITY MEDICAL OF UPPER EAST SIDE, PLLC (NPI# 1891339115) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891339115 |
| Entity Type | Organization |
| Organization Name | CITY MEDICAL OF UPPER EAST SIDE, PLLC |
| Practice Address |
129 Sunrise Hwy W Patchogue NY 11772-1846 |
| Mailing Address |
1345 Rxr Plz # 13th Uniondale NY 11556-1301 |
| Practice Telephone | 6312305775 |
| Practice Fax Number | 6312305775 |
| Mailing Telephone | 5164530435 |
| Mailing Fax Number | 6468463283 |
| Enumeration Date | 2019-10-30 |
| Last Update Date | 2019-10-30 |
| Authorized Official Name | MARLENA SIMPSON (VP, CREDENTIALING / ENROLLMENT) |
| Authorized Official Telephone | 5164530435 |
| Authorized Official Credential | CPMSM |
| Is Organization Subpart | Y |
| Parent Organization Name | CITY MEDICAL OF UPPER EAST SIDE, PLLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QU0200X |
Clinic/Center Specialization: Urgent Care |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558961961 | City Medical of Upper East Side, Pllc | Clinic/Center | 48 East 170th Street, Bronx, Ny 10452, Bronx, NY 10452 | 2020-10-27 |
| 1174122923 | City Medical of Upper East Side, Pllc | Clinic/Center | 1412 Broadway, New York, NY 10018-9228 | 2020-10-22 |
| 1932708773 | City Medical of Upper East Side, Pllc | Clinic/Center | 3780 E Tremont Ave, Bronx, NY 10465-2434 | 2020-10-22 |
| 1649899832 | City Medical of Upper East Side, Pllc | Clinic/Center | 424 S Broadway, Yonkers, NY 10705-2301 | 2020-04-09 |
| 1902425192 | City Medical of Upper East Side, Pllc | Clinic/Center | 3494 Jerome Ave, Bronx, NY 10467-1002 | 2020-04-09 |
| 1558980748 | City Medical of Upper East Side, Pllc | Clinic/Center | 10202 Liberty Ave, Ozone Park, NY 11417-1727 | 2020-04-09 |
| 1548889736 | City Medical of Upper East Side, Pllc | Clinic/Center | 22405 Jamaica Ave, Queens Village, NY 11428-2019 | 2020-04-09 |
| 1477197796 | City Medical of Upper East Side, Pllc | Clinic/Center | 1047 Southern Blvd, Bronx, NY 10459-3427 | 2019-10-30 |
| 1508400813 | City Medical of Upper East Side, Pllc | Clinic/Center | 1143 Lexington Ave, New York, NY 10075-0440 | 2019-10-30 |
| 1235770777 | City Medical of Upper East Side, Pllc | Clinic/Center | 25-18 Queens Plaza South, Long Island City, NY 11101 | 2019-10-07 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | CITY MEDICAL OF UPPER EAST SIDE, PLLC | 1345 Ave of The Americas, New York, NY 10105 |
| Street Address |
129 SUNRISE HWY W |
| City | PATCHOGUE |
| State | NY |
| Zip Code | 11772-1846 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205447224 | Amita Vipul Patel | Nurse Practitioner | Longlsland Community Hospital, 101 Hospital Rd, Patchogue, NY 11772 | 2020-08-13 |
| 1609491968 | Sanjib Dey | Family Medicine | Brookhaven Nephrology Associates, 260 E. Patchogue-yaphank Rd., Patchogue, NY 11772 | 2020-06-12 |
| 1992297204 | Camila Bueno-sanchez | Student in an Organized Health Care Education/Training Program | 676 S Country Rd, East Patchogue, NY 11772 | 2018-06-01 |
| 1184115859 | Premier Endodontics of Patchogue | Dentist | 44 Medford Avenue, Patchogue, NY 11772 | 2018-05-29 |
| 1801386453 | Franklin Ikechukwu Ugbode | Student in an Organized Health Care Education/Training Program | 100 Hospital Road Suite 201, Patchogue, NY 11772 | 2018-05-18 |
| 1508372335 | Stephanie Vanschaick | Counselor | 450 Waverly Ave Ste 11, Patchogue, NY 11772 | 2017-12-15 |
| 1578074498 | Chrystal Lee Curran | Specialist | 1116 Main Road, Aquebogue, NY 11772 | 2017-10-18 |
| 1013457712 | Candyce Fahner | Registered Nurse | 22 Haig Ave, E Patchogue, NY 11772 | 2017-02-28 |
| 1992251631 | Vanessa Lynn Petoello | Nurse Practitioner | 107 N/ Ocean Ave, Suite G, Patchogue, NY 11772 | 2016-09-01 |
| 1811343809 | Andrew Vanderlofske | Nurse Practitioner | 144 North Ocean Avenue, Patchogue, NY 11772 | 2016-05-09 |
| Find all providers in zip 11772 | ||||
| Taxonomy Code | 261QU0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Urgent Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457789778 | Patchogue Urgent Care, P.C. | Clinic/Center | 152 N Ocean Ave, Patchogue, NY 11772-2004 | 2013-10-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558961961 | City Medical of Upper East Side, Pllc | Clinic/Center | 48 East 170th Street, Bronx, Ny 10452, Bronx, NY 10452 | 2020-10-27 |
| 1174122923 | City Medical of Upper East Side, Pllc | Clinic/Center | 1412 Broadway, New York, NY 10018-9228 | 2020-10-22 |
| 1932708773 | City Medical of Upper East Side, Pllc | Clinic/Center | 3780 E Tremont Ave, Bronx, NY 10465-2434 | 2020-10-22 |
| 1932712049 | Lefferts Medical Associates PC | Clinic/Center | 808a Hicksville Rd, Massapequa, NY 11758-1262 | 2020-08-28 |
| 1619599578 | Rite Medical Care PC | Clinic/Center | 504 Myrtle Ave, Brooklyn, NY 11205-3542 | 2020-05-14 |
| 1649899832 | City Medical of Upper East Side, Pllc | Clinic/Center | 424 S Broadway, Yonkers, NY 10705-2301 | 2020-04-09 |
| 1902425192 | City Medical of Upper East Side, Pllc | Clinic/Center | 3494 Jerome Ave, Bronx, NY 10467-1002 | 2020-04-09 |
| 1558980748 | City Medical of Upper East Side, Pllc | Clinic/Center | 10202 Liberty Ave, Ozone Park, NY 11417-1727 | 2020-04-09 |
| 1548889736 | City Medical of Upper East Side, Pllc | Clinic/Center | 22405 Jamaica Ave, Queens Village, NY 11428-2019 | 2020-04-09 |
| 1851924294 | Tbhc Medical Services PC | Clinic/Center | 514 Fulton Street, Brooklyn, NY 11201 | 2020-02-13 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.