MMC AT NELSON AVE FAMILY RESIDENCE (NPI# 1104011436) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104011436 |
| Entity Type | Organization |
| Organization Name | MMC AT NELSON AVE FAMILY RESIDENCE |
| Practice Address |
Mmc At Nelson Ave Family Residence 1605 Nelson Avenue Bronx NY 10453-7068 |
| Mailing Address |
Cmo 100 Corporate Drive Yonkers NY 10701 |
| Practice Telephone | 9143774722 |
| Mailing Telephone | 9143774722 |
| Enumeration Date | 2007-09-10 |
| Last Update Date | 2007-09-10 |
| Authorized Official Name | MICHAEL G DOWLING (DIRECTOR) |
| Authorized Official Telephone | 9143774668 |
| Is Organization Subpart | Y |
| Parent Organization Name | MONTEFIORE MEDICAL CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
7000006H | NY | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437343100 | Mmc At Nelson Ave Family Residence | Clinic/Center | 1605 Nelson Avenue, Mmc At Nelson Ave Family Residence, Bronx, NY 10453-7068 | 2007-09-05 |
| Street Address |
MMC AT NELSON AVE FAMILY RESIDENCE 1605 NELSON AVENUE |
| City | BRONX |
| State | NY |
| Zip Code | 10453-7068 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316553225 | Victor Felipe | Occupational Therapist | 2042 Grand Avenue, Apartment 2d, Ny, Apt 2d, Bronx, NY 10453 | 2020-09-17 |
| 1033745849 | Jennifer Vargas | Student in an Organized Health Care Education/Training Program | Bronxcare Health Systems Dept of Dentistry, 1775 Grand Concourse 6th Floor, Bronx, NY 10453 | 2020-03-13 |
| 1457985038 | John Steven Contreras | Student in an Organized Health Care Education/Training Program | Bronxcare Health Systems, Dept of Dentistry, 1775 Grand Concourse 6th Floor, Bronx, NY 10453 | 2020-02-24 |
| 1538799648 | Ari Warshawsky | Counselor | Postgraduate Center for Mental Health, 1775 Grand Concourse, 8th Floor, Bronx, NY 10453 | 2020-01-17 |
| 1407403413 | Cristaly Williams | Behavioral Analyst | 2105 Jerome Avenue, Bronx, NY 10453 | 2019-08-23 |
| 1770041204 | Yei Won Lee | Student in an Organized Health Care Education/Training Program | Bronxcare Health Systems, Dental Dept, 1775 Grand Concourse, 6th Floor, Bronx, NY 10453 | 2019-03-04 |
| 1265905517 | William Alexander Jones Jr. | Behavior Technician | 1749grand Concourse, 1749 Grand Concourse Apt Ph8, Bronx, NY 10453 | 2019-01-09 |
| 1154810737 | Emily Patricia Mitchell | Occupational Therapist | 2105 Jerome Ave, Bronx, NY 10453 | 2018-05-09 |
| 1417445149 | Ashna N Shah | Student in an Organized Health Care Education/Training Program | Bronx Lebanon Hospital Center 6 Th Floor, 1775 Grand Concourse, Bronx, NY 10453 | 2018-04-27 |
| 1700384328 | Kevin Ponce Obate | Physical Therapist | 1975 University Ave, Bronx, NY 10453 | 2018-01-29 |
| Find all providers in zip 10453 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386093367 | Alegria Operating LLC | Clinic/Center | 3475 Third Ave, Bronx, NY 10456-4811 | 2016-06-09 |
| 1093142861 | Dedicated Acquisition Strategies Inc | Clinic/Center | 682-684 E 233rd Street, Bronx, NY 10466 | 2013-10-10 |
| 1326337890 | Valley Medical Services, P.C. | Clinic/Center | 3000 Eastchester Rd, Bronx, NY 10469-3202 | 2011-04-05 |
| 1548490766 | Montefiore Medical Center | Clinic/Center | 1521 Jarrett Pl, Bronx, NY 10461-2606 | 2009-07-22 |
| 1639309982 | Montefiore Medical Center | Clinic/Center | 1754 Randall Avenue, Mmc Aecom Substance Abuse, Bronx, NY 10473 | 2009-07-21 |
| 1780819540 | Bronx Pulmonary Center LLC | Clinic/Center | 441 E Tremont Ave, Bronx, NY 10457-4301 | 2009-05-22 |
| 1851580872 | Mmc At 3514 Wayne Avenue | Clinic/Center | Mmc At 3514 Wayne Avenue, 3514 Wayne Avenue, Bronx, NY 10467-1564 | 2007-10-16 |
| 1083809263 | Mmc Jarret Place Practice | Clinic/Center | 1516 Jarret Place, Mmc Jarret Place Practice, Bronx, NY 10461-2607 | 2007-09-11 |
| 1437344611 | Mmc Jamaica Assessment Center | Clinic/Center | 175-10 88th Avenue, Mmc Jamaica Assessment Center, Bronx, NY 11432-5720 | 2007-09-11 |
| 1629263801 | Mmc Johnson Avenue Practice | Clinic/Center | 3510 Johnson Avenue, Mmc Johnson Avenue Practice, Bronx, NY 10463-1603 | 2007-09-11 |
| Find all providers in BRONX | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.