Three Graces Medical Practice PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

176524 Issued in NY

Legal business name

THREE GRACES MEDICAL PRACTICE PLLC

Practice address

550 E 180TH St
Bronx, NY 10457-3304

Phone

(718) 933-0333

Fax

(718) 933-0337

NPI assigned

Sep 1, 2011

Last updated

Sep 12, 2011By 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

Dr. Myra White, M.D.

Title

President

Phone

(718) 933-0333

Specialties & licenses 4

Addresses

Other identifiers 1

Locations

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.

• Irwin Abraham, M.D.

  • Sports Medicine (Internal Medicine) Physician
  • New York, NY
  • NPI 1548338411
  NPD (past)

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

{
    "created_epoch": "1314835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315785600000",
    "number": "1831470939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 E 180TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104573304",
            "telephone_number": "718-933-0333",
            "fax_number": "718-933-0337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 E 180TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104573304",
            "telephone_number": "718-933-0333",
            "fax_number": "718-933-0337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THREE GRACES MEDICAL PRACTICE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-01",
        "last_updated": "2011-09-12",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "MYRA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-933-0333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "176524",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "176524",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "176524",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "176524",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01512445",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Bronx, NY
• Providers in Bronx, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2011; 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.