Impact Medical PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

205919 Issued in NY

Legal business name

IMPACT MEDICAL PC

Practice address

552 E 180TH St
Bronx, NY 10457-3304

Phone

(718) 933-4445

Fax

(718) 933-4444

NPI assigned

Mar 7, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Dean Anthony Basulto, MD

Title

Solo Owner

Phone

(718) 665-2900

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1362614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362614400000",
    "number": "1861733370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "552 E 180TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104573304",
            "telephone_number": "718-933-4445",
            "fax_number": "718-933-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "552 E 180TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104573304",
            "telephone_number": "718-933-4445",
            "fax_number": "718-933-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACT MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-07",
        "last_updated": "2013-03-07",
        "status": "A",
        "authorized_official_last_name": "BASULTO",
        "authorized_official_first_name": "DEAN",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "SOLO OWNER",
        "authorized_official_telephone_number": "718-665-2900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "205919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Annalisa Imperia, RN
• Imperial Pharmacy Inc.
• Sarah Kate Sivan Import
• Important Steps, Inc.
• Hubert Kofi Impraim, RN

• Internal Medicine Physician in Bronx, NY
• Providers in Bronx, 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 Mar 7, 2013; 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.