Provider Type Icon

COMPREHENSIVE COMMUITY DEVELOPMENT CORPORATION NPI 1669636577


NPI Information

NPI: 1669636577
Provider Name: COMPREHENSIVE COMMUITY DEVELOPMENT CORPORATION

Other Name: DIALLO MEDICAL CENTER

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

Specialization: Federally Qualified Health Center (FQHC)

Address:
1760 WESTCHESTER AVE
BRONX, NY
ZIP 10472
Phone: (718) 892-8474
Get Directions

COMPREHENSIVE COMMUITY DEVELOPMENT CORPORATION is a federally qualified health center (fqhc) clinic center in Bronx, NY. COMPREHENSIVE COMMUITY DEVELOPMENT CORPORATION NPI is 1669636577. The provider is registered as an organization entity type.
The provider Other Name Is Diallo Medical Center.

The provider's business location address is:

1760 WESTCHESTER AVE
BRONX, NY
ZIP 10472-022
Phone: (718) 892-8474
Fax: (718) 892-4311

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 7/10/2008 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
100665274MEDICAIDNEW YORK
2=========OTHERNEW YORKTAX ID

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.