Provider Demographics
NPI:1174988802
Name:MY CARE URGENT CARE LLC
Entity type:Organization
Organization Name:MY CARE URGENT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:H
Authorized Official - Last Name:LEBOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-576-2273
Mailing Address - Street 1:108 HILLSIDE BLVD
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-3148
Mailing Address - Country:US
Mailing Address - Phone:732-576-2273
Mailing Address - Fax:732-806-3315
Practice Address - Street 1:108 HILLSIDE BLVD
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-3148
Practice Address - Country:US
Practice Address - Phone:732-576-2273
Practice Address - Fax:732-806-3315
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-23
Last Update Date:2017-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07198800261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center