| Dtc | |
|
1250 Waters Pl Tower 1 Suite 602 Bronx NY 10461-2720 | |
| (347) 640-6050 | |
| Not Available |
| Full Name | Dtc |
|---|---|
| Speciality | Clinic/center |
| Location | 1250 Waters Pl, Bronx, New York |
| Authorized Official Name and Position | Richard Rosen (VP OF FINANCE) |
| Authorized Official Contact | 3476406050 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dtc 1250 Waters Pl Tower 1 Suite 602 Bronx NY 10461-2720 Ph: (347) 640-6050 | Dtc 1250 Waters Pl Tower 1 Suite 602 Bronx NY 10461-2720 Ph: (347) 640-6050 |
| NPI Number | 1043431349 |
|---|---|
| Provider Enumeration Date | 05/02/2007 |
| Last Update Date | 03/09/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043431349 | NPI | - | NPPES |
| 01353222 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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