NPIMap

Organization Active NPI

Comprehensive Commuity Development Corporation

  • Federally Qualified Health Center (FQHC)
  • Bronx, NY
National Provider Identifier
1659534907
Registry record updated Jun 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
7000239R Issued in NY
Legal business name
COMPREHENSIVE COMMUITY DEVELOPMENT CORPORATION
Practice address
616 Castle Hill Ave
Bronx, NY 10473-1402
Phone
(718) 239-9013
Fax
(718) 794-0468
NPI assigned
Jul 8, 2008
Organization subpart
Yes
Parent organization
COMPREHENSIVE COMMUNITY DEVELOPMENT CORP.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 21, 2018

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

Authorized official

Name
Pedro Espada Jr.
Title
President & Ceo
Phone
(718) 589-2232

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 7000239R NY Primary

Addresses

Primary practice location

616 Castle Hill Ave
Bronx, NY 10473-1402

Mailing address

731 White Plains Rd
Bronx, NY 10473-2631
Phone (718) 589-8324

Other identifiers 1

IdentifierTypeStateIssuer
00665274MedicaidNY

Other names 1

  • Jessica Guzman Medical Center Other name

National Provider Directory

National Provider Directory
Part of
Joseph Avanzato

NPI Registry JSON

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

{
    "created_epoch": "1215475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1659534907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "731 WHITE PLAINS RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104732631",
            "telephone_number": "718-589-8324",
            "fax_number": "718-860-1838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 CASTLE HILL AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104731402",
            "telephone_number": "718-239-9013",
            "fax_number": "718-794-0468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPREHENSIVE COMMUITY DEVELOPMENT CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMPREHENSIVE COMMUNITY DEVELOPMENT CORP.",
        "enumeration_date": "2008-07-08",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "ESPADA",
        "authorized_official_first_name": "PEDRO",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "718-589-2232",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NY",
            "license": "7000239R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00665274",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jessica Guzman Medical Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Jun 21, 2018; 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.