Healthcare Provider Details

I. General information

NPI: 1881138766
Provider Name (Legal Business Name): BRONXVILLE INTERNAL MEDICINE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2016
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1561 WESTCHESTER AVE
BRONX NY
10472-2912
US

IV. Provider business mailing address

1561 WESTCHESTER AVE
BRONX NY
10472-2912
US

V. Phone/Fax

Practice location:
  • Phone: 718-328-6200
  • Fax:
Mailing address:
  • Phone: 718-328-6200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MAZAN RABADI
Title or Position: PRESIDENT/CEO
Credential: M.D.
Phone: 914-771-9286