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1501 Jerome Ave Bronx NY 10452-3309 | |
| (718) 294-8160 | |
| (718) 294-8161 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Student Health |
| Location | 1501 Jerome Ave, Bronx, New York |
| Authorized Official Name and Position | Michael G Dowling (CHIEF ADMIN OFFICER) |
| Authorized Official Contact | 9143774668 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1501 Jerome Ave Bronx NY 10452-3309 Ph: (718) 294-8160 | 1501 Jerome Ave Bronx NY 10452-3309 Ph: (718) 294-8160 |
| NPI Number | 1164768206 |
|---|---|
| Provider Enumeration Date | 12/18/2012 |
| Last Update Date | 12/18/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164768206 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QS1000X | Clinic/center - Student Health | (* (Not Available)) | Primary |
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