| Andrade Medical Pllc | |
|
1163 Manor Ave Frnt 2 Bronx NY 10472-3972 | |
| (718) 589-3501 | |
| (718) 589-1012 |
| Full Name | Andrade Medical Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1163 Manor Ave Frnt 2, Bronx, New York |
| Authorized Official Name and Position | David Jacob (CRED MANAGER) |
| Authorized Official Contact | 3476502775 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Andrade Medical Pllc 1163 Manor Ave Frnt 2 Bronx NY 10472-3972 Ph: (718) 589-3501 | Andrade Medical Pllc 1163 Manor Ave Frnt 2 Bronx NY 10472-3972 Ph: (718) 589-3501 |
| NPI Number | 1801123617 |
|---|---|
| Provider Enumeration Date | 11/16/2009 |
| Last Update Date | 12/08/2023 |
| Medicare PECOS PAC ID | 8921481789 |
|---|---|
| Medicare Enrollment ID | O20220811003452 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801123617 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Abdalla I. Adam |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1295885374 PECOS PAC ID: 1052414687 Enrollment ID: I20070320000019 |
| Provider Name | Arkadiy Abraham Murdakhayev |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003450487 PECOS PAC ID: 9133516677 Enrollment ID: I20220502000151 |
| Provider Name | Joseph Andrade |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881848422 PECOS PAC ID: 9335461904 Enrollment ID: I20220608001422 |
| Provider Name | Ben Osuala |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699068965 PECOS PAC ID: 8820469919 Enrollment ID: I20230127002632 |
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