334 Medical PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

205919 Issued in NY

Legal business name

334 MEDICAL PC

Practice address

334 Grand Concourse
Bronx, NY 10451-5409

Phone

(718) 993-0200

Fax

(718) 993-0204

NPI assigned

Jun 25, 2012

Organization subpart

No

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

Authorized official

Name

Dean Basulto

Title

M.D

Phone

(718) 993-0200

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1340582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340582400000",
    "number": "1982968939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "334 GRAND CONCOURSE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104515409",
            "telephone_number": "718-993-0200",
            "fax_number": "718-993-0204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "334 GRAND CONCOURSE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104515409",
            "telephone_number": "718-993-0200",
            "fax_number": "718-993-0204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "334 MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-25",
        "last_updated": "2012-06-25",
        "status": "A",
        "authorized_official_last_name": "BASULTO",
        "authorized_official_first_name": "DEAN",
        "authorized_official_title_or_position": "M.D",
        "authorized_official_telephone_number": "718-993-0200"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "205919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Bronx, NY
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2012; 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.