Organization Active NPI

Ruben U. Carvajal MDPC

  • Primary Care Clinic/Center
  • Bronx, NY
National Provider Identifier
1841500469
Registry record updated Oct 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
150807 Issued in NY
Legal business name
RUBEN U. CARVAJAL MDPC
Practice address
2271 Grand Ave
Bronx, NY 10468-6905
Phone
(718) 733-2621
Fax
(718) 733-3839
NPI assigned
Oct 16, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2010

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

Authorized official

Name
Ruben U. Carvajal, MDNPI 1588764021
Title
President
Phone
(718) 733-2621

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 150807 NY Primary

Addresses

Primary practice location

2271 Grand Ave
Bronx, NY 10468-6905

Mailing address

2271 Grand Ave
Bronx, NY 10468-6905
Phone (718) 733-2621

Other identifiers 1

IdentifierTypeStateIssuer
00812102MedicaidNY

National Provider Directory

National Provider Directory

Locations

2271 Grand Ave
Bronx, NY 10468
Phone (718) 733-2621

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1287187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287187200000",
    "number": "1841500469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2271 GRAND AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104686905",
            "telephone_number": "718-733-2621",
            "fax_number": "718-733-3839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2271 GRAND AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104686905",
            "telephone_number": "718-733-2621",
            "fax_number": "718-733-3839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUBEN U. CARVAJAL MDPC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-16",
        "last_updated": "2010-10-16",
        "status": "A",
        "authorized_official_last_name": "CARVAJAL",
        "authorized_official_first_name": "RUBEN",
        "authorized_official_middle_name": "U.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-733-2621",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NY",
            "license": "150807",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00812102",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Oct 16, 2010; 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.