Individual provider · Type 1 NPI

Juan Marcos Urraca Mata, MD

Student in an Organized Health Care Education/Training Program · Elmhurst, NY

NPI number 1114767738 Active · reactivated Sep 30, 2025

Practice location

79-01 Broadway
Elmhurst, NY 11373

Call (718) 334-3437 Map

Mailing address

111-45 76th Drive, Apt. D2
Forest Hills, NY 11375

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

118 other providers at this address

Other student in an organized health care education/training program providers in Elmhurst

See all in Elmhurst →

About NPI 1114767738

Juan Marcos Urraca Mata, MD's National Provider Identifier is 1114767738, issued on May 30, 2024. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Elmhurst, NY. The record was last updated on Sep 30, 2025.