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General NPI Number Information
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NPI Number | 1346775350
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Entity Type | Organization
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Legal Business Name | HAMILTON MEDICAL PLAZA PC
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Dates
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Enumeration Date | 04/27/2017
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Last Update Date | 04/27/2017
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Provider Practice Location Address
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Address Line | 820 SAINT ANNS AVE
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City | BRONX
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State | NY
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Zip | 10456-7885
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Country | US
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Telephone | 718-215-8280
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Fax | 718-744-2842
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Provider Business Mailing Address
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Address Line | 1865 AMSTERDAM AVE
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City | NEW YORK
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State | NY
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Zip | 10031-1716
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Country | US
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Telephone | 718-215-8280
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Fax | 718-744-2842
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Authorized Official
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Title or Position | OWNER
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Name | DR. JEAN YVES DASTAIN
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Credential | MD
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Telephone | 718-215-8280
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number |
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License Number State |
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