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NPI Code Detail

MEDICARE: BRONX HARBOR HEALTH CARE COMPLEX, INC.

MEDICARE: BRONX HARBOR HEALTH CARE COMPLEX, INC.
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 Physician7000372NNY
2363L00000XNurse Practitioner7000372NNY
3314000000XSkilled Nursing Facility7000372NNY

Other Identifiers

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

General Provider Information

NPI Number : 1952395626
Entity Type Code : Organization
Provider Name (Legal Business Name) : BRONX HARBOR HEALTH CARE COMPLEX, INC.
Provider Business Mailing Address
First Line : 2000 E GUN HILL RD
Second Line :
City : BRONX
State : NY
Zip : 10469-6016
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2000 E GUN HILL RD
Second Line :
City : BRONX
State : NY
Zip : 10469-6016
Country : US
Telephone Number : 718-320-0400
Fax Number :
Authorized Official
Title or Position : ADMINISTRATOR
Name : MR. ALEX STERN
Credential :
Telephone Number : 718-320-0400
Provider Enumeration Date : 09/08/2005
Last Update Date : 07/23/2014

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