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NPI Code Detail

MEDICARE: BRONX PSYCHIATRIC CENTER

MEDICARE: BRONX PSYCHIATRIC CENTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1302R00000XHealth Maintenance OrganizationNY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1346307550
Entity Type Code : Organization
Provider Name (Legal Business Name) : BRONX PSYCHIATRIC CENTER
Provider Business Mailing Address
First Line : 44 HOLLAND AVE
Second Line :
City : ALBANY
State : NY
Zip : 12229-0001
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1500 WATERS PL
Second Line :
City : BRONX
State : NY
Zip : 10461-2723
Country : US
Telephone Number : 718-931-0600
Fax Number :
Authorized Official
Title or Position : DIRECTOR, FINANCE
Name : ROBERT PUCCIO
Credential :
Telephone Number : 518-473-0795
Provider Enumeration Date : 01/03/2007
Last Update Date : 08/01/2008

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Directions to “BRONX PSYCHIATRIC CENTER ” Practice Location

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