Healthcare Provider Details

I. General information

NPI: 1003093436
Provider Name (Legal Business Name): BRIGHTPOINT HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2008
Last Update Date: 10/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1543-1545 INWOOD AVENUE
BRONX NY
10452-2001
US

IV. Provider business mailing address

248 W 35TH ST 8TH FLOOR
NEW YORK NY
10001-2505
US

V. Phone/Fax

Practice location:
  • Phone: 855-687-8700
  • Fax: 718-294-4765
Mailing address:
  • Phone: 718-681-8700
  • Fax: 646-380-1322

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number7000277R
License Number StateNY

VIII. Authorized Official

Name: EVAN ZUCKERMAN
Title or Position: CHIEF FISCAL OFFICER
Credential: CPA
Phone: 718-681-8700