MEDICARE: NEIGHBORHOOD MEDICAL 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
1	261QM1300X	Multi-Specialty Clinic/Center

General Provider Information

NPI Number	:	1427654292
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEIGHBORHOOD MEDICAL PC

Provider Business Mailing Address
First Line	:	PO BOX 1607
Second Line	:
City	:	WEST BABYLON
State	:	NY
Zip	:	11704-0607
Country	:	US
Telephone Number	:	917-453-8417
Fax Number	:	917-471-9216

Provider Business Practice Location Address
First Line	:	1343 WEBSTER AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10456-1805
Country	:	US
Telephone Number	:	917-453-8417
Fax Number	:	917-471-9216

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MORYAM LADOTUN
Credential	:
Telephone Number	:	917-453-8417

Provider Enumeration Date	:	12/08/2020
Last Update Date	:	09/11/2024

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Directions to “NEIGHBORHOOD MEDICAL PC ” Practice Location

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