| Marc Vital-herne Physician,p.c | |
|
2016 Bronxdale Ave Suite # 101 Bronx NY 10462-3388 | |
| (718) 918-1102 | |
| (718) 918-9756 |
| Full Name | Marc Vital-herne Physician,p.c |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 2016 Bronxdale Ave, Bronx, New York |
| Authorized Official Name and Position | Marc Vital-herne (PREISDENT) |
| Authorized Official Contact | 5164106946 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Marc Vital-herne Physician,p.c 2016 Bronxdale Ave Suite # 101 Bronx NY 10462-3388 Ph: (718) 918-1102 | Marc Vital-herne Physician,p.c 2016 Bronxdale Ave Suite # 101 Bronx NY 10462-3388 Ph: (718) 918-1102 |
| NPI Number | 1669612966 |
|---|---|
| Provider Enumeration Date | 02/26/2009 |
| Last Update Date | 02/26/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669612966 | NPI | - | NPPES |
| 01591244 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 197500 (New York) | Primary |
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