BRONXCARE HEALTH SYSTEM NPI 1053790147

NPI Information

NPI: 1053790147
Provider Name: BRONXCARE HEALTH SYSTEM
Classification: Clinic/Center - 261QF0400X
Specialization: Federally Qualified Health Center (FQHC)
Entity Type: Organization
Doing Business As: AMBULATORY CARE NETWORK
CLIA Number: 33D2192885
Address: 1650 GRAND CONCOURSE
BRONX, NY
ZIP 10457
Phone: (718) 901-8600

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NPI Details

BRONXCARE HEALTH SYSTEM is a federally qualified health center (fqhc) clinic center in Bronx, NY. BRONXCARE HEALTH SYSTEM NPI is 1053790147. The provider is registered as an organization entity type.
The provider Is Doing Business As Ambulatory Care Network.

The provider's business location address is:

1650 GRAND CONCOURSE
BRONX, NY
ZIP 10457
Phone: (718) 901-8600
Fax: (718) 293-1457

The provider's authorized official is Victor G Demarco .
The authorized official title is Senior Vp-chief Financial Officer and has the following contact phone number (718) 901-8600.

The CLIA number assigned to this NPI record is 33D2192885 - ancillary testing site in health care center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/22/2015 and was last updated on 5/31/2018.

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	License Number	License State	Primary
1	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)	7000001H	NEW YORK	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	000163N	OTHER	NEW YORK	BLUE CROSS
2	00476022	MEDICAID	NEW YORK

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: 3/30/2025

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