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General NPI Number Information
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NPI Number | 1326389016
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Entity Type | Organization
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Legal Business Name | NORTH CENTRAL BRONX HOSPITAL
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Dates
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Enumeration Date | 03/06/2013
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Last Update Date | 03/06/2013
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Provider Practice Location Address
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Address Line | 3424 KOSSUTH AVENUE ROOM 3A MEDICINE
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City | BRONX
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State | NY
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Zip | 10467
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Country | US
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Telephone | 719-519-3349
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Fax |
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Provider Business Mailing Address
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Address Line | 3424 KOSSUTH AVENUE ROOM 3A MEDICINE
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City | BRONX
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State | NY
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Zip | 10467
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ASSOCIATE DIRECTOR OF NURSING
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Name | SUSAN MAYER
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Credential |
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Telephone | 718-519-3349
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 651453
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License Number State | NY
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