334 Grand Concourse Medical PC

Primary specialty

Urology PhysicianTaxonomy code 208800000X

Legal business name

334 GRAND CONCOURSE MEDICAL PC

Practice address

444 Willis Ave
Bronx, NY 10455-4013

Phone

(718) 841-7392

Fax

(347) 862-2711

NPI assigned

Jun 26, 2019

Last updated

Jul 6, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Errol C Mallett, MD

Title

President

Phone

(718) 841-7392

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1561507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593993600000",
    "number": "1225699648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 WILLIS AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104554013",
            "telephone_number": "718-841-7392",
            "fax_number": "347-862-2711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 WILLIS AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104554013",
            "telephone_number": "718-841-7392",
            "fax_number": "347-862-2711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "334 GRAND CONCOURSE MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-26",
        "last_updated": "2020-07-06",
        "certification_date": "2020-07-06",
        "status": "A",
        "authorized_official_last_name": "MALLETT",
        "authorized_official_first_name": "ERROL",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-841-7392",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Urology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2020; 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.