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General NPI Number Information
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NPI Number | 1205949997
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Entity Type | Organization
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Legal Business Name | CASTLE HILL MEDICAL OF NEW YORK, INC.
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Dates
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Enumeration Date | 08/16/2006
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Last Update Date | 10/12/2016
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Provider Practice Location Address
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Address Line | 920 CASTLE HILL AVE
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City | BRONX
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State | NY
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Zip | 10473-1320
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Country | US
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Telephone | 718-824-0500
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Fax | 718-824-2373
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Provider Business Mailing Address
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Address Line | 920 CASTLE HILL AVE
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City | BRONX
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State | NY
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Zip | 10473-1320
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Country | US
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Telephone | 718-824-0500
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Fax | 718-824-2373
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Authorized Official
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Title or Position | CEO
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Name | MR. SAM RAHAT-MUTQADIR
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Credential |
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Telephone | 718-824-0500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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