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NPI Code Detail

MEDICARE: DIAGNOSTIC PC

MEDICARE: DIAGNOSTIC PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractorX0124901NY

General Provider Information

NPI Number : 1033589221
Entity Type Code : Organization
Provider Name (Legal Business Name) : DIAGNOSTIC PC
Provider Business Mailing Address
First Line : 2451 E TREMONT AVE
Second Line :
City : BRONX
State : NY
Zip : 10461-2801
Country : US
Telephone Number : 718-239-3123
Fax Number : 718-822-1387
Provider Business Practice Location Address
First Line : 2451 E TREMONT AVE
Second Line :
City : BRONX
State : NY
Zip : 10461-2801
Country : US
Telephone Number : 718-239-3123
Fax Number : 718-822-1387
Authorized Official
Title or Position : PRESIDENT
Name : GERLANDO ZAMBUTO
Credential : DC
Telephone Number : 561-843-2661
Provider Enumeration Date : 09/30/2015
Last Update Date : 09/30/2015

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