Provider Demographics
NPI:1336426667
Name:STATCARE URGENT & WALK IN MEDICAL CARE PLLC
Entity type:Organization
Organization Name:STATCARE URGENT & WALK IN MEDICAL CARE PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:PRITI
Authorized Official - Middle Name:
Authorized Official - Last Name:JAIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-938-1550
Mailing Address - Street 1:135 MINEOLA BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-3917
Mailing Address - Country:US
Mailing Address - Phone:917-310-3371
Mailing Address - Fax:516-938-1554
Practice Address - Street 1:135 MINEOLA BLVD STE A
Practice Address - Street 2:
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-3917
Practice Address - Country:US
Practice Address - Phone:917-310-3371
Practice Address - Fax:516-938-1554
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-15
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG10006804OtherMEDICARE PTAN