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1227 Edward L Grant Hwy Bronx Medical And Wellness Center Bronx NY 10452-3101 | |
(718) 716-4400 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 1227 Edward L Grant Hwy, Bronx, New York |
Authorized Official Name and Position | Lourdes Clemente (SR. MANAGER, REVENUE CYCLE) |
Authorized Official Contact | 7187164000 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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85 W Burnside Ave Bronx NY 10453-4015 Ph: (718) 924-2686 | 1227 Edward L Grant Hwy Bronx Medical And Wellness Center Bronx NY 10452-3101 Ph: (718) 716-4400 |
NPI Number | 1669912341 |
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Provider Enumeration Date | 03/01/2017 |
Last Update Date | 12/13/2024 |
Medicare PECOS PAC ID | 3072798172 |
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Medicare Enrollment ID | O20170608000578 |
Identifier | Type | State | Issuer |
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1669912341 | NPI | - | NPPES |
04890319 | Medicaid | NY |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 7000236R (New York) | Primary |
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