NPIMap

Organization Active NPI

Ny Comprehensive Medical Wellness P.C.

  • Dermatopathology Physician
  • Bronx, NY
National Provider Identifier
1912419698
Registry record updated Nov 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatopathology PhysicianTaxonomy code 207ND0900X
License
288165 Issued in NY
Legal business name
NY COMPREHENSIVE MEDICAL WELLNESS P.C.
Practice address
329 E 149TH St
Bronx, NY 10451-5625
Phone
(718) 585-5500
Fax
(718) 585-5502
NPI assigned
Nov 2, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2017

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

Authorized official

Name
Michael Sorace, MD
Title
Managing Employee
Phone
(830) 331-9900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatopathology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ND0900X 288165 NY Primary

Addresses

Primary practice location

329 E 149TH St
Bronx, NY 10451-5625

Mailing address

2 S End Ave Apt TH8
New York, NY 10280-1089
Phone (830) 331-9900

Other identifiers 1

IdentifierTypeStateIssuer
115644OtherNYNYSED ID

National Provider Directory

National Provider Directory

Locations

329 E 149th St
Bronx, NY 10451

14732 Jamaica Ave
Lowr
Jamaica, NY 11435
Phone (718) 206-2002

Practitioners & affiliated clinicians

Practitioners 38

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 38

NPI Registry JSON

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

{
    "created_epoch": "1509580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1509580800000",
    "number": "1912419698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 S END AVE APT TH8",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "102801089",
            "telephone_number": "830-331-9900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "329 E 149TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104515625",
            "telephone_number": "718-585-5500",
            "fax_number": "718-585-5502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NY COMPREHENSIVE MEDICAL WELLNESS P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-02",
        "last_updated": "2017-11-02",
        "status": "A",
        "authorized_official_last_name": "SORACE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "MANAGING EMPLOYEE",
        "authorized_official_telephone_number": "830-331-9900",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ND0900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Dermatopathology",
            "state": "NY",
            "license": "288165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYSED ID",
            "identifier": "115644",
            "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 Nov 2, 2017; 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.