Provider Demographics
NPI:1154408136
Name:URGO, JAMES R (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:R
Last Name:URGO
Suffix:
Gender:M
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 CENTRAL AVE STE B
Mailing Address - Street 2:
Mailing Address - City:DUNKIRK
Mailing Address - State:NY
Mailing Address - Zip Code:14048-2137
Mailing Address - Country:US
Mailing Address - Phone:716-363-6050
Mailing Address - Fax:
Practice Address - Street 1:310 CENTRAL AVE STE B
Practice Address - Street 2:
Practice Address - City:DUNKIRK
Practice Address - State:NY
Practice Address - Zip Code:14048-2125
Practice Address - Country:US
Practice Address - Phone:716-363-6050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY333263363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00026502207OtherUNIVERA-MERCY HEALTH
NY02202239Medicaid
NY00026502205OtherUNIVERA
NY9512388OtherIHA
NY071227000048OtherFIDELIS-HOLLAND
NY000560720008OtherBC/BS-HOLLAND
NY080320000057OtherFIDELIS-MERCY HEALTH
NY000560720009OtherBC/BS-MERCY HEALTH
NY00026502205OtherUNIVERA
D02288Medicare UPIN