| Medinova Physicians Pllc | |
|
814 E 156th St Bronx NY 10455-1714 | |
| (718) 665-0223 | |
| Not Available |
| Full Name | Medinova Physicians Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 814 E 156th St, Bronx, New York |
| Authorized Official Name and Position | Vijay K Alla (MD) |
| Authorized Official Contact | 7186650223 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medinova Physicians Pllc 814 E. 156 Street Bronx NY 10455 Ph: () - | Medinova Physicians Pllc 814 E 156th St Bronx NY 10455-1714 Ph: (718) 665-0223 |
| NPI Number | 1740425545 |
|---|---|
| Provider Enumeration Date | 12/08/2008 |
| Last Update Date | 09/14/2011 |
| Medicare PECOS PAC ID | 5294886560 |
|---|---|
| Medicare Enrollment ID | O20090626000037 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740425545 | NPI | - | NPPES |
| 211607 | Other | NY | STATE LICENSE NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 211607 (New York) | Primary |
| Provider Name | Venkata R Ravi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346289048 PECOS PAC ID: 4789677659 Enrollment ID: I20040406001350 |
| Provider Name | Vijay K Alla |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598748592 PECOS PAC ID: 2062465271 Enrollment ID: I20050228001048 |
| Provider Name | Joe W Chamberlin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912103227 PECOS PAC ID: 6608921770 Enrollment ID: I20090826000453 |
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