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BRONXCARE DR. MARTIN LUTHER KING JR. HEALTH CENTER NPI 1619275039


NPI Information

NPI: 1619275039
Provider Name: BRONXCARE DR. MARTIN LUTHER KING JR. HEALTH CENTER

Doing Business As: BRONXCARE DENTAL SERVICES

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
1775 GRAND CONCOURSE
BRONX, NY
ZIP 10453
Phone: (718) 901-8600
Get Directions

BRONXCARE DR. MARTIN LUTHER KING JR. HEALTH CENTER is a federally qualified health center (fqhc) clinic center in Bronx, NY. BRONXCARE DR. MARTIN LUTHER KING JR. HEALTH CENTER NPI is 1619275039. The provider is registered as an organization entity type.
The provider Is Doing Business As Bronxcare Dental Services.

The provider's business location address is:

1775 GRAND CONCOURSE
BRONX, NY
ZIP 10453
Phone: (718) 901-8600
Fax: (718) 293-1475

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 enumeration date for this NPI number is 3/9/2011 and was last updated on 6/28/2018.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QF0400XClinic/CenterFederally Qualified Health Center (FQHC)7000212RNEW YORKYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1W0437OTHERNEW YORKBLUE CROSS
203410919MEDICAIDNEW 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: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.