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COMPREHENSIVE COMMUITY DEVELOPMENT CORPORATION NPI 1659534907


NPI Information

NPI: 1659534907
Provider Name: COMPREHENSIVE COMMUITY DEVELOPMENT CORPORATION

Other Name: JESSICA GUZMAN MEDICAL CENTER

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

Specialization: Federally Qualified Health Center (FQHC)

Address:
616 CASTLE HILL AVE
BRONX, NY
ZIP 10473
Phone: (718) 239-9013
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COMPREHENSIVE COMMUITY DEVELOPMENT CORPORATION is a federally qualified health center (fqhc) clinic center in Bronx, NY. COMPREHENSIVE COMMUITY DEVELOPMENT CORPORATION NPI is 1659534907. The provider is registered as an organization entity type.
The provider Other Name Is Jessica Guzman Medical Center.

The provider's business location address is:

616 CASTLE HILL AVE
BRONX, NY
ZIP 10473-402
Phone: (718) 239-9013
Fax: (718) 794-0468

The provider's authorized official is Pedro Espada .
The authorized official title is President & Ceo and has the following contact phone number (718) 589-2232.

The enumeration date for this NPI number is 7/8/2008 and was last updated on 6/21/2018.


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)7000239RNEW 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
1=========OTHERNEW YORKTAX ID
200665274MEDICAIDNEW 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

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