Healthcare Provider Details
I. General information
NPI: 1730522848
Provider Name (Legal Business Name): FIRST STEP MEDICAL, P C
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/09/2013
Last Update Date: 11/11/2024
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
743 EAST TREMONT AVE.
BRONX NY
10457-5101
US
IV. Provider business mailing address
743 EAST TREMONT AVE.
BRONX NY
10457-5101
US
V. Phone/Fax
- Phone: 718-220-0507
- Fax: 718-220-8419
- Phone: 718-220-0507
- Fax: 718-220-8419
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MARIA
M
MOLINA
Title or Position: OWNER
Credential: MD
Phone: 718-220-0507