NPIMap

Organization Active NPI

MMC at 3514 Dekalb Avenue

  • Primary Care Clinic/Center
  • Bronx, NY
National Provider Identifier
1083802250
Registry record updated Oct 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
7000006H Issued in NY
Legal business name
MMC AT 3514 DEKALB AVENUE
Practice address
MMC at 3514 Dekalb Avenue
3514 Dekalb Avenue
Bronx, NY 10467-1205
Phone
(914) 377-4722
NPI assigned
Oct 12, 2007
Last updated
Oct 12, 2007By the provider in NPPES
Organization subpart
Yes
Parent organization
MONTEFIORE MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 12, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Michael G Dowling
Title
Director
Phone
(914) 377-4668

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 7000006H NY Primary

Addresses

Primary practice location

MMC at 3514 Dekalb Avenue
3514 Dekalb Avenue
Bronx, NY 10467-1205

Mailing address

Cmo
100 Corporate Drive
Yonkers, NY 10701
Phone (914) 377-4722

National Provider Directory

National Provider Directory
Tax ID family
MMC Rehab Medicine520 organizations share this tax ID, including this one
Part of
MMC Rehab Medicine

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

3514 DeKalb Ave
Bronx, NY 10467
Phone (347) 418-4724

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1192147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192147200000",
    "number": "1083802250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CMO",
            "address_2": "100 CORPORATE DRIVE",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "10701",
            "telephone_number": "914-377-4722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MMC AT 3514 DEKALB AVENUE",
            "address_2": "3514 DEKALB AVENUE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104671205",
            "telephone_number": "914-377-4722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MMC AT 3514 DEKALB AVENUE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MONTEFIORE MEDICAL CENTER",
        "enumeration_date": "2007-10-12",
        "last_updated": "2007-10-12",
        "status": "A",
        "authorized_official_last_name": "DOWLING",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "914-377-4668"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NY",
            "license": "7000006H",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.