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GRAND CONCOURSE MEDICAL PRACTICE P.C. NPI 1265744197


NPI Information

NPI: 1265744197
Provider Name: GRAND CONCOURSE MEDICAL PRACTICE, P.C.
Classification: Internal Medicine - 207R00000X
Entity Type: Organization

CLIA Number: 33D2011030

Address:
1831 GRAND CONCOURSE STE A
BRONX, NY
ZIP 10453
Phone: (646) 640-6246
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GRAND CONCOURSE MEDICAL PRACTICE, P.C. is an internal medicine in Bronx, NY. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. GRAND CONCOURSE MEDICAL PRACTICE, P.C. NPI is 1265744197. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1831 GRAND CONCOURSE STE A
BRONX, NY
ZIP 10453-324
Phone: (646) 640-6246

The provider's authorized official is Manuel E Mejia .
The authorized official title is Medical Director and has the following contact phone number (646) 640-6246.

The CLIA number assigned to this NPI record is 33D2011030 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/8/2010 and was last updated on 10/21/2016.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207R00000XInternal Medicine241121NEW YORKYes

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

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