MEDICARE: BRONXVILLE INTERNAL MEDICINE PC

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
1	207RI0200X	Infectious Disease Physician
2	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1881138766
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRONXVILLE INTERNAL MEDICINE PC

Provider Business Mailing Address
First Line	:	1561 WESTCHESTER AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10472-2912
Country	:	US
Telephone Number	:	718-328-6200
Fax Number	:

Provider Business Practice Location Address
First Line	:	1561 WESTCHESTER AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10472-2912
Country	:	US
Telephone Number	:	718-328-6200
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	MAZAN RABADI
Credential	:	M.D.
Telephone Number	:	914-771-9286

Provider Enumeration Date	:	12/12/2016
Last Update Date	:	05/06/2026

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