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General NPI Number Information
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NPI Number | 1003062266
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Entity Type | Organization
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Legal Business Name | AVRAHAM Y HENOCH MD PC
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Dates
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Enumeration Date | 08/07/2008
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Last Update Date | 11/30/2010
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Provider Practice Location Address
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Address Line | 564 W 160TH ST
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City | NEW YORK
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State | NY
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Zip | 10032-6702
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Country | US
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Telephone | 212-740-6400
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Fax | 212-740-4105
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Provider Business Mailing Address
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Address Line | 2685 GRAND CONCOURSE
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City | BRONX
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State | NY
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Zip | 10468-3746
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Country | US
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Telephone | 718-563-0500
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Fax | 718-563-3706
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Authorized Official
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Title or Position | OWNER
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Name | DR. AVRAHAM Y. HENOCH
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Credential | M.D.
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Telephone | 212-740-6400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 168125
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License Number State | NY
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