Providence Medical Services PLLC

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

License

287577 Issued in NY

Legal business name

PROVIDENCE MEDICAL SERVICES PLLC

Practice address

203 Gramatan Ave
Mount Vernon, NY 10550-1291

Phone

(860) 212-9306

NPI assigned

Mar 29, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Dharini Sun, MD

Title

Medical Director

Phone

(860) 212-9306

Specialties & licenses 1

Addresses

Other names 1

• AFC Urgent Care Mount Vernon Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1522281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522281600000",
    "number": "1417452467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 POVERTY HOLLOW RD",
            "city": "NEWTOWN",
            "state": "CT",
            "postal_code": "064701800",
            "telephone_number": "860-212-9306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 GRAMATAN AVE",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105501291",
            "telephone_number": "860-212-9306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE MEDICAL SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-29",
        "last_updated": "2018-03-29",
        "status": "A",
        "authorized_official_last_name": "SUN",
        "authorized_official_first_name": "DHARINI",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "860-212-9306",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NY",
            "license": "287577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AFC Urgent Care Mount Vernon",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Urgent Care Clinic/Center in Mount Vernon, NY
• Providers in Mount Vernon, NY by specialty
• Urgent Care Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.