Bronx Medical Associates PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

187770 Issued in NY

Legal business name

BRONX MEDICAL ASSOCIATES PLLC

Practice address

65-11 Booth Street
Suite 1C
Rego Park, NY 11374-4184

Phone

(718) 806-1434

Fax

(718) 806-1435

NPI assigned

Jan 10, 2014

Last updated

Jan 10, 2014By 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

Marvin J Base, M.D.NPI 1366401853

Title

President

Phone

(718) 806-1434

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Marvin J Base, M.D.

  • Internal Medicine Physician
  • Rego Park, NY
  • NPI 1366401853
  Authorized official Same address or phone

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

{
    "created_epoch": "1389312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389312000000",
    "number": "1689096646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65-11 BOOTH STREET",
            "address_2": "SUITE 1C",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113744184",
            "telephone_number": "718-806-1434",
            "fax_number": "718-806-1435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65-11 BOOTH STREET",
            "address_2": "SUITE 1C",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113744184",
            "telephone_number": "718-806-1434",
            "fax_number": "718-806-1435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRONX MEDICAL ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-10",
        "last_updated": "2014-01-10",
        "status": "A",
        "authorized_official_last_name": "BASE",
        "authorized_official_first_name": "MARVIN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-806-1434",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "187770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Rego Park, NY
• Providers in Rego Park, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2014; 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.