COMPREHENSIVE COMMUITY DEVELOPMENT CORPORATION NPI 1821252743

NPI Information

NPI: 1821252743
Provider Name: COMPREHENSIVE COMMUITY DEVELOPMENT CORPORATION

Other Name: BURNSIDE MEDICAL CENTER

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

Specialization: Federally Qualified Health Center (FQHC)

Address:
165 E BURNSIDE AVE
BRONX, NY
ZIP 10453
Phone: (718) 539-0003
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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 1821252743. The provider is registered as an organization entity type.
The provider Other Name Is Burnside Medical Center.

The provider's business location address is:

165 E BURNSIDE AVE
BRONX, NY
ZIP 10453-104
Phone: (718) 539-0003
Fax: (718) 569-9054

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)	7000239R	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	=========	OTHER	NEW YORK	TAX ID
2	00665274	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: 11/14/2023

NPI Synchronization or Removal

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