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General NPI Number Information
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NPI Number | 1609030956
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Entity Type | Organization
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Legal Business Name | BRONX COMPREHENSIVE HEMATOLOGY-ONCOLOGY, PLLC
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Dates
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Enumeration Date | 07/16/2008
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Last Update Date | 07/16/2008
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Provider Practice Location Address
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Address Line | 4487 3RD AVE FOURTH FLOOR
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City | BRONX
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State | NY
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Zip | 10457-1526
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Country | US
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Telephone | 718-960-6377
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Fax | 718-960-5522
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Provider Business Mailing Address
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Address Line | 243 PARK HILL AVE
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City | YONKERS
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State | NY
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Zip | 10705-1436
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Country | US
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Telephone | 914-423-2029
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Fax | 914-423-2029
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. ILMANA FULGER
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Credential | MD
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Telephone | 914-423-2029
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 243615
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License Number State | NY
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