| Family Medicine Center | |
|
1276 Fulton Ave 3rd Floor Bronx NY 10456 | |
| (718) 901-8600 | |
| (718) 293-1475 |
| Full Name | Family Medicine Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 1276 Fulton Ave 3rd Floor, Bronx, New York |
| Authorized Official Name and Position | Victor G Demarco (SENIOR VP-CHIEF FINANCIAL OFFICIER) |
| Authorized Official Contact | 7189018600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Medicine Center 1276 Fulton Ave Bronx NY 10456-3402 Ph: (718) 901-8600 | Family Medicine Center 1276 Fulton Ave 3rd Floor Bronx NY 10456 Ph: (718) 901-8600 |
| NPI Number | 1306190558 |
|---|---|
| Provider Enumeration Date | 11/08/2012 |
| Last Update Date | 06/28/2018 |
| Medicare PECOS PAC ID | 3870404429 |
|---|---|
| Medicare Enrollment ID | O20130618000790 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306190558 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 7000001H (New York) | Primary |
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