| Grand Concourse Medical Practice, P.c. | |
|
1831 Grand Concourse Ste A Bronx NY 10453-6324 | |
| (646) 640-6246 | |
| Not Available |
| Full Name | Grand Concourse Medical Practice, P.c. |
|---|---|
| Speciality | Internal Medicine |
| Location | 1831 Grand Concourse Ste A, Bronx, New York |
| Authorized Official Name and Position | Manuel E Mejia (MEDICAL DIRECTOR) |
| Authorized Official Contact | 6466406246 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Grand Concourse Medical Practice, P.c. 1831 Grand Concourse Ste A Bronx NY 10453-6324 Ph: (646) 640-6246 | Grand Concourse Medical Practice, P.c. 1831 Grand Concourse Ste A Bronx NY 10453-6324 Ph: (646) 640-6246 |
| NPI Number | 1265744197 |
|---|---|
| Provider Enumeration Date | 07/08/2010 |
| Last Update Date | 10/21/2016 |
| Medicare PECOS PAC ID | 3072701259 |
|---|---|
| Medicare Enrollment ID | O20110414000387 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265744197 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 241121 (New York) | Primary |
| Provider Name | Manuel E Mejia |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114035193 PECOS PAC ID: 9335146984 Enrollment ID: I20061025000184 |
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