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1040 Havemeyer Ave Bronx NY 10462-5382 | |
| (718) 863-6200 | |
| (914) 530-2178 |
| Full Name | |
|---|---|
| Speciality | Clinic/center |
| Location | 1040 Havemeyer Ave, Bronx, New York |
| Authorized Official Name and Position | Kenneth Gelb (CEO) |
| Authorized Official Contact | 7188636200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1070 Havemeyer Ave Bronx NY 10462-5310 Ph: (718) 863-6200 | 1040 Havemeyer Ave Bronx NY 10462-5382 Ph: (718) 863-6200 |
| NPI Number | 1144655689 |
|---|---|
| Provider Enumeration Date | 09/03/2013 |
| Last Update Date | 09/03/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144655689 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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