| Diabetes Relief Center Of Bronx Mso Llc | |
|
2825 3rd Ave Ste 200 Bronx NY 10455-4066 | |
| (916) 550-1050 | |
| (916) 550-1238 |
| Full Name | Diabetes Relief Center Of Bronx Mso Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2825 3rd Ave Ste 200, Bronx, New York |
| Authorized Official Name and Position | Deane' Wallace (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 9165719041 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Diabetes Relief Center Of Bronx Mso Llc 4441 Auburn Blvd Ste J Sacramento CA 95841-4139 Ph: (916) 550-1050 | Diabetes Relief Center Of Bronx Mso Llc 2825 3rd Ave Ste 200 Bronx NY 10455-4066 Ph: (916) 550-1050 |
| NPI Number | 1043738586 |
|---|---|
| Provider Enumeration Date | 09/05/2017 |
| Last Update Date | 09/05/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043738586 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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