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General NPI Number Information
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NPI Number | 1023551413
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Entity Type | Organization
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Legal Business Name | MID-BRONX ENDOSCOPY CENTER LLC
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Dates
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Enumeration Date | 12/02/2016
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Last Update Date | 11/04/2025
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Provider Practice Location Address
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Address Line | 51 WEST BURNSIDE AVE
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City | BRONX
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State | NY
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Zip | 10453-4038
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Country | US
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Telephone | 917-791-6004
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Fax | 917-720-3998
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Provider Business Mailing Address
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Address Line | 51 W BURNSIDE AVE
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City | BRONX
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State | NY
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Zip | 10453-4037
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Country | US
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Telephone | 971-791-6004
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Fax | 917-720-3998
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | CELINE VASQUEZ
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Credential |
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Telephone | 917-791-6004
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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