334 Grand Concourse Medical PC
Organization Active NPI Urology Physician · Bronx, NY
NPI 1225699648 · NPPES record last updated Jul 6, 2020
Key facts
- NPI
- 1225699648
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Urology Physician 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
- Organization subpart
- No
Authorized official
- Name
- Errol C Mallett, MD
- Title
- President
- Phone
- (718) 841-7392
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician |
208800000X | Yes |
Addresses
Primary practice location
444 Willis Ave
Bronx, NY 10455-4013
Mailing address
444 Willis Ave
Bronx, NY 10455-4013
Phone (718) 841-7392
Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 6, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.