| Full Name | |
|---|---|
| Speciality | Clinic/center |
| Location | 260 E 188th St, Bronx, New York |
| Authorized Official Name and Position | Michael G Dowling (CAO) |
| Authorized Official Contact | 9143774668 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
260 E 188th St Bronx NY 10458-5302 Ph: (718) 618-8920 | 260 E 188th St Bronx NY 10458-5302 Ph: (718) 618-8920 |
| NPI Number | 1043644701 |
|---|---|
| Provider Enumeration Date | 08/29/2013 |
| Last Update Date | 08/29/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043644701 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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