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Mmc Medical Park At 1635 Poplar

Clinic/Center, Primary Care in Bronx, NY. Organization (NPI-2).

NPI number1003000779
StatusActive
Last updated in NPPESSep 5, 2007

Details

NPI
1003000779
Entity type
Organization (NPI-2)
Legal business name
Mmc Medical Park At 1635 Poplar
Organization subpart
Yes
Enumeration date
Sep 5, 2007
Last updated
Sep 5, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QP2300X Clinic/Center, Primary Care7000006HNYYes

Practice location

Mmc Medical Park At 1635 Poplar
1635 Poplar Street
Bronx, NY 10461-2659

Phone 914-377-4722

Mailing address

Cmo
100 Corporate Drive
Yonkers, NY 10701

Phone 914-377-4722

Authorized official

Michael G Dowling
Director
9143774668

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