| Bronx Community Medicine, Pllc | |
|
2676 Grand Concourse # A Bronx NY 10458-4914 | |
| (718) 708-4040 | |
| (718) 708-6040 |
| Full Name | Bronx Community Medicine, Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2676 Grand Concourse # A, Bronx, New York |
| Authorized Official Name and Position | Yohanna Maria Olivo Mercedes (MD) |
| Authorized Official Contact | 3472043437 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bronx Community Medicine, Pllc 2676 Grand Concourse A Bronx NY 10458-4914 Ph: (718) 708-4040 | Bronx Community Medicine, Pllc 2676 Grand Concourse # A Bronx NY 10458-4914 Ph: (718) 708-4040 |
| NPI Number | 1942645247 |
|---|---|
| Provider Enumeration Date | 05/01/2013 |
| Last Update Date | 09/29/2014 |
| Medicare PECOS PAC ID | 9830333814 |
|---|---|
| Medicare Enrollment ID | O20140218001339 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942645247 | NPI | - | NPPES |
| 268781YH9B. | Other | NJ | MEDICARE PTAN |
| A100097539 | Other | NY | MEDICARE PTAN |
| 0333794 | Medicaid | NJ | |
| 003250800 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 266860 (New York) | Primary |
| Provider Name | Vincent Brandeis |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1215053962 PECOS PAC ID: 4587705892 Enrollment ID: I20100108000625 |
| Provider Name | Sophia Lubin |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1659526085 PECOS PAC ID: 0648420372 Enrollment ID: I20121015000603 |
| Provider Name | Yohanna Maria Olivo Mercedes |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639346869 PECOS PAC ID: 8921280488 Enrollment ID: I20140218001445 |
| Provider Name | Angela Marizol Castillo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528682770 PECOS PAC ID: 0244644474 Enrollment ID: I20210130000016 |
| Provider Name | Ashley Marie Cardona |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225700982 PECOS PAC ID: 4183010804 Enrollment ID: I20220406001304 |
| Provider Name | Nathalie Toribio |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235747684 PECOS PAC ID: 3577005248 Enrollment ID: I20240610001382 |
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