Healthcare Provider Details

I. General information

NPI: 1295851103
Provider Name (Legal Business Name): EASTCHESTER MEDICAL ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 11/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2426 EASTCHESTER RD STE 208
BRONX NY
10469-5916
US

IV. Provider business mailing address

2426 EASTCHESTER RD STE 208
BRONX NY
10469-5916
US

V. Phone/Fax

Practice location:
  • Phone: 718-708-5650
  • Fax: 718-708-5619
Mailing address:
  • Phone: 718-708-5650
  • Fax: 718-708-5619

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. EVIA ALIKAJ NANO
Title or Position: PHYSICIAN
Credential: MD
Phone: 718-708-5650