MEDICARE: BRONX PRIMARY CARE

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
1	208D00000X	General Practice Physician	115361-2	NY

General Provider Information

NPI Number	:	1427489715
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRONX PRIMARY CARE

Provider Business Mailing Address
First Line	:	3184 GRAND CONCOURSE
Second Line	:	SUITE 2B
City	:	BRONX
State	:	NY
Zip	:	10458-1007
Country	:	US
Telephone Number	:	718-584-0555
Fax Number	:	718-584-8555

Provider Business Practice Location Address
First Line	:	3184 GRAND CONCOURSE
Second Line	:	SUITE 2B
City	:	BRONX
State	:	NY
Zip	:	10458-1007
Country	:	US
Telephone Number	:	718-367-0010
Fax Number	:	718-584-8555

Authorized Official
Title or Position	:	MD
Name	:	DR. THAKOR C RANA
Credential	:	MD
Telephone Number	:	718-584-0555

Provider Enumeration Date	:	12/11/2013
Last Update Date	:	12/11/2013

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Practice Location Address:

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Practice Location Address:

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1508019191 — AVS ARTHRITIS & ASSOCIATES PC
Practice Location Address:

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Directions to “BRONX PRIMARY CARE ” Practice Location

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