Organization Active NPI

Downtown Bronx Medical Associates P.C.

  • Surgical Physician Assistant
  • New York, NY
National Provider Identifier
1790833028
Registry record updated Aug 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
006007 Issued in NY
Legal business name
DOWNTOWN BRONX MEDICAL ASSOCIATES P.C.
Practice address
506 Malcolm X Blvd
New York, NY 10037-1802
Phone
(212) 939-1649
NPI assigned
Jan 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2008

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

Authorized official

Name
Mr. Peter I. Gordon
Title
Executive Administrator
Phone
(718) 579-6017

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AS0400X 006007 NY Primary

Addresses

Primary practice location

506 Malcolm X Blvd
New York, NY 10037-1802

Mailing address

3465 Ichabod CT
Yorktown Heights, NY 10598-2113
Phone (917) 841-0102

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219104000000",
    "number": "1790833028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3465 ICHABOD CT",
            "city": "YORKTOWN HEIGHTS",
            "state": "NY",
            "postal_code": "105982113",
            "telephone_number": "917-841-0102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 MALCOLM X BLVD",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100371802",
            "telephone_number": "212-939-1649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOWNTOWN BRONX MEDICAL ASSOCIATES P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-05",
        "last_updated": "2008-08-19",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "I.",
        "authorized_official_title_or_position": "EXECUTIVE ADMINISTRATOR",
        "authorized_official_telephone_number": "718-579-6017",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "006007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2008; 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.