NPI | 1073811485 |
---|---|
Other Name | BRONXCARE 174TH ST MEDICAL PRACTICE |
Entity Type | Organization |
Authorized Contact | VICTOR GEORGE DEMARCO SVP CFO 718-901-8600 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: NY 7000212R) |
Enumeration Date | 2011-03-09 |
Last Update Date | 2025-09-26 |