| Promesa Inc | |
|
1776 Clay Avenue Bronx NY 10457 | |
| (718) 299-1100 | |
| (718) 716-7822 |
| Full Name | Promesa Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1776 Clay Avenue, Bronx, New York |
| Authorized Official Name and Position | Vicky Gatell (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 7189607568 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Promesa Inc 311 E 175th St Bronx NY 10457-5859 Ph: (718) 960-7568 | Promesa Inc 1776 Clay Avenue Bronx NY 10457 Ph: (718) 299-1100 |
| NPI Number | 1407830946 |
|---|---|
| Provider Enumeration Date | 11/29/2005 |
| Last Update Date | 09/23/2022 |
| Medicare PECOS PAC ID | 5395634539 |
|---|---|
| Medicare Enrollment ID | O20040315000368 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407830946 | NPI | - | NPPES |
| 00245294 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 7000226R (New York) | Primary |
| Provider Name | Daniel Rosa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568592962 PECOS PAC ID: 7810886553 Enrollment ID: I20040311001161 |
| Provider Name | Emmanuel A Gachette |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306874979 PECOS PAC ID: 7214942093 Enrollment ID: I20060215000484 |
| Provider Name | Peter Marcus |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881624997 PECOS PAC ID: 4183713308 Enrollment ID: I20071212000365 |
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