Organization Active NPI

Resource Medical Clinic LLC

  • Primary Care Clinic/Center
  • Staten Island, NY
National Provider Identifier
1972287464
Registry record updated Jun 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
RESOURCE MEDICAL CLINIC LLC
Practice address
480 Netherland Ave
Staten Island, NY 10303-1828
Phone
(203) 745-8432
NPI assigned
Jun 14, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2023

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

Authorized official

Name
Michael Kwakye, MDNPI 1104232040
Title
Founder
Phone
(203) 745-8432

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

480 Netherland Ave
Staten Island, NY 10303-1828

Mailing address

480 Netherland Ave
Staten Island, NY 10303-1828

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1686700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686700800000",
    "number": "1972287464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 NETHERLAND AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103031828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 NETHERLAND AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103031828",
            "telephone_number": "203-745-8432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESOURCE MEDICAL CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-14",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A",
        "authorized_official_last_name": "KWAKYE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "203-745-8432",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2023; 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.