PERRY AVE FAMILY MEDICAL CENTER INC NPI 1619973518

NPI Information

NPI: 1619973518
Provider Name: PERRY AVE FAMILY MEDICAL CENTER INC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 33D2277450

Address:
3071 PERRY AVE
BRONX, NY
ZIP 10467
Phone: (718) 231-6700
Get Directions

PERRY AVE FAMILY MEDICAL CENTER INC is a family medicine in Bronx, NY. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. PERRY AVE FAMILY MEDICAL CENTER INC NPI is 1619973518. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3071 PERRY AVE
BRONX, NY
ZIP 10467-111
Phone: (718) 231-6700
Fax: (718) 515-5454

The provider's authorized official is Shama R Khan .
The authorized official title is Operations Manager and has the following contact phone number (718) 231-6700.

The CLIA number assigned to this NPI record is 33D2277450 - community clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/24/2005 and was last updated on 7/8/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	207KA0200X	Allergy & Immunology	Allergy	No
2	207R00000X	Internal Medicine		No
3	207V00000X	Obstetrics & Gynecology		No
4	208000000X	Pediatrics		No
5	207Q00000X	Family Medicine		Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	2478450	OTHER	NEW YORK	UNITED HEALTH CARE
2	02444553	MEDICAID	NEW YORK
3	041227000012	OTHER	NEW YORK	FIDELIS
4	7829562	OTHER	NEW YORK	AETNA
5	2000416	OTHER	NEW YORK	GHI
6	S70F11	OTHER	NEW YORK	BLUE CROSS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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