| Advanced Preventive Medicine | |
|
1030 Sheridan Ave Bronx NY 10456 | |
| (516) 971-1824 | |
| Not Available |
| Full Name | Advanced Preventive Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 1030 Sheridan Ave, Bronx, New York |
| Authorized Official Name and Position | Lidia Virgil (PRESIDENT/CEO) |
| Authorized Official Contact | 5169711824 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Preventive Medicine 5030 Broadway Ste 818 New York NY 10034-1670 Ph: (212) 567-4931 | Advanced Preventive Medicine 1030 Sheridan Ave Bronx NY 10456 Ph: (516) 971-1824 |
| NPI Number | 1497240683 |
|---|---|
| Provider Enumeration Date | 06/29/2018 |
| Last Update Date | 08/08/2018 |
| Medicare PECOS PAC ID | 4587902697 |
|---|---|
| Medicare Enrollment ID | O20190215000992 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497240683 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Kathleen G Beltran |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407234503 PECOS PAC ID: 8224342571 Enrollment ID: I20150731014482 |
| Provider Name | Mythily Ramanathan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235657925 PECOS PAC ID: 4587910054 Enrollment ID: I20180713001280 |
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