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NPI Code Detail

MEDICARE: BRONX STATE HOSPITAL

MEDICARE: BRONX STATE HOSPITAL
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
1283Q00000XPsychiatric HospitalP46503NY

General Provider Information

NPI Number : 1215010988
Entity Type Code : Organization
Provider Name (Legal Business Name) : BRONX STATE HOSPITAL
Provider Business Mailing Address
First Line : 341 S 6TH AVE
Second Line :
City : MOUNT VERNON
State : NY
Zip : 10550-4113
Country : US
Telephone Number : 718-862-5409
Fax Number :
Provider Business Practice Location Address
First Line : 1500 WATERS PL
Second Line :
City : BRONX
State : NY
Zip : 10461-2723
Country : US
Telephone Number : 718-862-5409
Fax Number :
Authorized Official
Title or Position : CHILD & ADOLESCENT PSYCHIATRIST
Name : DR. EMMANUEL TOCHUKWU OKEKE
Credential : MD
Telephone Number : 718-862-5409
Provider Enumeration Date : 10/24/2006
Last Update Date : 06/27/2008

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Directions to “BRONX STATE HOSPITAL ” Practice Location

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