Healthcare Provider Details

I. General information

NPI: 1972821585
Provider Name (Legal Business Name): BRONX ENDOSCOPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2010
Last Update Date: 05/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3584 JEROME AVENUE BRONX ENDOSCOPY
BRONX NY
10467
US

IV. Provider business mailing address

6740 W DEER VALLEY RD STE. D 107-255
GLENDALE AZ
85310-5953
US

V. Phone/Fax

Practice location:
  • Phone: 718-231-4443
  • Fax: 718-708-4821
Mailing address:
  • Phone: 602-298-2653
  • Fax: 602-298-2686

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0800X
TaxonomyEndoscopy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: PROF. MEIR SALAMA
Title or Position: DIRECTOR
Credential: M.D.
Phone: 718-231-4443