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NPI Code Detail

MEDICARE: DR. RACHEL I BERMUDEZ MD

MEDICARE: DR. RACHEL I BERMUDEZ MD
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
1207R00000XInternal Medicine Physician192193NY

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
301621287OTHERNYMEDICARE ID

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1235110776
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RACHEL I BERMUDEZ MD
Provider Business Mailing Address
First Line : 1650 GRAND CONCOURSE
Second Line :
City : BRONX
State : NY
Zip : 10457-7606
Country : US
Telephone Number : 718-590-1800
Fax Number : 718-518-5740
Provider Business Practice Location Address
First Line : 1650 GRAND CONCOURSE
Second Line :
City : BRONX
State : NY
Zip : 10457-7606
Country : US
Telephone Number : 718-590-1800
Fax Number : 718-518-5740
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/10/2005
Last Update Date : 06/05/2015

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