NPIMap

Organization Active NPI

MMC at Nelson Ave Family Residence

  • Multi-Specialty Clinic/Center
  • Bronx, NY
National Provider Identifier
1104011436
Registry record updated Sep 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
License
7000006H Issued in NY
Legal business name
MMC AT NELSON AVE FAMILY RESIDENCE
Practice address
MMC at Nelson Ave Family Residence
1605 Nelson Avenue
Bronx, NY 10453-7068
Phone
(914) 377-4722
NPI assigned
Sep 10, 2007
Last updated
Sep 10, 2007By the provider in NPPES
Organization subpart
Yes
Parent organization
MONTEFIORE MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 10, 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
Multi-Specialty Clinic/Center 261QM1300X 7000006H NY Primary

Addresses

Primary practice location

MMC at Nelson Ave Family Residence
1605 Nelson Avenue
Bronx, NY 10453-7068

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

NPI Registry JSON

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

{
    "created_epoch": "1189382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189382400000",
    "number": "1104011436",
    "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 NELSON AVE FAMILY RESIDENCE",
            "address_2": "1605 NELSON AVENUE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104537068",
            "telephone_number": "914-377-4722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MMC AT NELSON AVE FAMILY RESIDENCE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MONTEFIORE MEDICAL CENTER",
        "enumeration_date": "2007-09-10",
        "last_updated": "2007-09-10",
        "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": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "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 Sep 10, 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.