| Concourse Pediatrics | |
|
1001 Grand Concourse Apt 1e Bronx NY 10452-9122 | |
| (718) 293-3566 | |
| (718) 293-3547 |
| Full Name | Concourse Pediatrics |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 1001 Grand Concourse Apt 1e, Bronx, New York |
| Authorized Official Name and Position | Juan J Pilarte (PRESIDENT) |
| Authorized Official Contact | 7182933566 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Concourse Pediatrics 1001 Grand Concourse Apt 1e Bronx NY 10452-9122 Ph: (718) 293-3566 | Concourse Pediatrics 1001 Grand Concourse Apt 1e Bronx NY 10452-9122 Ph: (718) 293-3566 |
| NPI Number | 1699200154 |
|---|---|
| Provider Enumeration Date | 04/21/2017 |
| Last Update Date | 04/21/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699200154 | NPI | - | NPPES |
| 01596501 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 199747 (New York) | Primary |
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