| Urban Family Doctor, Pllc | |
|
185 Ocean Ave # 1a Brooklyn NY 11225-4763 | |
| (347) 669-0017 | |
| (347) 472-0571 |
| Full Name | Urban Family Doctor, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 185 Ocean Ave # 1a, Brooklyn, New York |
| Authorized Official Name and Position | Amanda Harris (SOLE OWNER) |
| Authorized Official Contact | 3476690017 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Urban Family Doctor, Pllc 185 Ocean Ave # 1a Brooklyn NY 11225-4763 Ph: (347) 669-0017 | Urban Family Doctor, Pllc 185 Ocean Ave # 1a Brooklyn NY 11225-4763 Ph: (347) 669-0017 |
| NPI Number | 1710535836 |
|---|---|
| Provider Enumeration Date | 09/02/2019 |
| Last Update Date | 12/26/2019 |
| Medicare PECOS PAC ID | 8628309929 |
|---|---|
| Medicare Enrollment ID | O20191018000277 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710535836 | NPI | - | NPPES |
| 04658779 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Amanda Leigh Harris |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861759623 PECOS PAC ID: 0446581748 Enrollment ID: I20191018000422 |
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