Active NPI
Downtown Bronx Medical Associates P.C.
- Surgical Physician Assistant
- New York, NY
National Provider Identifier
1790833028
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- 006007
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 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 DirectoryNPI 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.