Healthcare Provider Details

I. General information

NPI: 1013426865
Provider Name (Legal Business Name): BEBSY ESTEFAN MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3050 CORLEAR AVE # PHB
BRONX NY
10463-5180
US

IV. Provider business mailing address

3050 CORLEAR AVE # PHB
BRONX NY
10463-5180
US

V. Phone/Fax

Practice location:
  • Phone: 347-248-8145
  • Fax:
Mailing address:
  • Phone: 347-248-8145
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: BEBSY C ESTEFAN
Title or Position: OWNER
Credential:
Phone: 347-248-8145