Basic Information
Provider Information
NPI: 1790724193
EntityType: 2
ReplacementNPI:  
OrganizationName: EMURGENT CARE MEDICINE PLLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: EMURGENT CARE PLLC
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 11835 RT 9W
Address2:  
City: WEST COXSACKIE
State: NY
PostalCode: 121923605
CountryCode: US
TelephoneNumber: 5187319000
FaxNumber: 5187319119
Practice Location
Address1: 11835 RT 9W
Address2:  
City: WEST COXSACKIE
State: NY
PostalCode: 121923605
CountryCode: US
TelephoneNumber: 5187319000
FaxNumber: 5187319119
Other Information
ProviderEnumerationDate: 06/04/2006
LastUpdateDate: 01/31/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: HASSETT
AuthorizedOfficialFirstName: PAMELA
AuthorizedOfficialMiddleName: T
AuthorizedOfficialTitleorPosition: CFO
AuthorizedOfficialTelephone: 5187319000
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MRS.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000X  Y193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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