MMC AT JACKSON AVE FAMILY RESIDENCE (NPI# 1285829507) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285829507 |
| Entity Type | Organization |
| Organization Name | MMC AT JACKSON AVE FAMILY RESIDENCE |
| Practice Address |
Mmc At Jackson Ave Family Residence 691 East 138th Street Bronx NY 10454-3307 |
| 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 |
|---|---|---|---|---|
| 1326232091 | Mmc At Jackson Ave Family Residence | Clinic/Center | 691 East 138th Street, Mmc At Jackson Ave Family Residen, Bronx, NY 10454-3307 | 2007-09-05 |
| Street Address |
MMC AT JACKSON AVE FAMILY RESIDENCE 691 EAST 138TH STREET |
| City | BRONX |
| State | NY |
| Zip Code | 10454-3307 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679044762 | Roland Koduah | Pharmacist | 537-539 East 138th Street, Bronx, NY 10454 | 2018-12-16 |
| 1407369416 | Noor Kazi LLC | Psychiatry & Neurology | 679 East 138 Street, Bronx, Fl.1, Bronx, NY 10454 | 2017-11-13 |
| 1982122628 | Jacob Mauro Dominguez | Licensed Practical Nurse | 223 Brook Av, Bronx, NY 10454 | 2017-09-01 |
| 1730618182 | Geanell Compton | Speech-Language Pathologist | 345 Brook Avenue, Bronx, NY 10454 | 2017-06-08 |
| 1285084053 | Everlaines Chapman Viltres | Registered Nurse | 426 E 141st St Apt 2, Bronx, NY 10454 | 2016-06-13 |
| 1790154466 | Damian Family Care Centers, Inc. | Clinic/Center | 2604 3rd Avenue, Bronx, NY 10454 | 2015-09-23 |
| 1073904975 | Alexis Acevedo | Counselor | 14 Bruckner Blvd Ste 3e, Bronx, NY 10454 | 2015-02-12 |
| 1609266949 | Andira Pena | Licensed Practical Nurse | 803 East 138th Street, Bronx, NY 10454 | 2015-01-26 |
| 1154675833 | Niki Patel | Occupational Therapist | 468 East 140th Street, Bronx, NY 10454 | 2012-11-02 |
| 1851697395 | New Superior Radio Group, Corp. | Taxi | 133 Lincoln Avenue, Bronx, NY 10454 | 2011-02-01 |
| Find all providers in zip 10454 | ||||
| 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.