THE PAC PROGRAM OF THE BRONX (NPI# 1497981328) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497981328 |
| Entity Type | Organization |
| Organization Name | THE PAC PROGRAM OF THE BRONX |
| Practice Address |
1215 Stratford Ave Bronx NY 10472-2501 |
| Practice Telephone | 7183282605 |
| Practice Fax Number | 7183282609 |
| Mailing Telephone | 7183282605 |
| Mailing Fax Number | 7183282609 |
| Enumeration Date | 2009-06-05 |
| Last Update Date | 2009-06-08 |
| Authorized Official Name | DR. KEVIN L ROSS (CEO/PRESIDENT) |
| Authorized Official Telephone | 7183282605 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | 100411691 | NY | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | NEW YORK STATE OPERATING CERTIFICATE | 100411691 | 01 |
| Street Address |
1215 STRATFORD AVE |
| City | BRONX |
| State | NY |
| Zip Code | 10472-2501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063517944 | Morris Park Physical Therapy Services PC | Physical Therapist | 1215 Stratford Ave, Suite 13, Bronx, NY 10472-2501 | 2006-09-14 |
| 1073837282 | Marie Anne Reyes | Physical Therapist | 1215 Stratford Ave, Suite 13, Bronx, NY 10472-2501 | 2010-03-16 |
| 1497995476 | Evelyn Burroughs | Counselor | 1215 Stratford Ave, Bronx, NY 10472-2501 | 2009-03-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386276541 | United Cerebral Palsy of Nyc Inc | Intermediate Care Facility, Mentally Retarded | 1841-1845 Lacombe Ave, Bronx, NY 10472 | 2020-02-06 |
| 1497288641 | Claudia Dongmo | Licensed Practical Nurse | 1129 St Lawrence Ave Apt 1a, Bronx, NY 10472 | 2017-04-05 |
| 1952763310 | Amanda Mohammed | Case Manager/Care Coordinator | 1259 Boynton Ave, Bronx, NY 10472 | 2016-03-24 |
| 1669861928 | Ercilia Lopez | Counselor | 1134 Colgate Ave, Apt 4c, Bronx, NY 10472 | 2015-01-09 |
| 1548681448 | Melissa A Diaz | Occupational Therapist | 1575 East 174th Street Apt 13c, Bronx, NY 10472 | 2013-12-18 |
| 1346670973 | Advanced Diagnostic Services Inc | Physiological Laboratory | 1268 White Plains Road., R # 6 (ground Level Shaikh), Bronx, NY 10472 | 2013-11-18 |
| 1366708497 | Rashida U Adil | Registered Nurse | 1025 Morrison Avenue, Jhs 123, Bronx, NY 10472 | 2012-04-03 |
| 1467699637 | Pharmacy Plus Surgical Supplies Inc | Pharmacy | 1770 D Westchester Ave, Bronx, NY 10472 | 2009-01-09 |
| 1144408006 | Gladys Ramona Torres-ortiz | Psychologist | 1764 Weshchester Ave, Bronx, NY 10472 | 2008-02-03 |
| 1346367505 | Nasser M Tejaratchi | Internal Medicine | 1101 White Plains Road, Ph, Bronx, NY 10472 | 2007-03-23 |
| Find all providers in zip 10472 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679190326 | Payless Staffing and Consultants | Clinic/Center | 1332 Commerce Ave Frnt 3, Bronx, NY 10461-3612 | 2020-06-29 |
| 1891327813 | Montefiore Medcial Center | Clinic/Center | 3860 E Tremont Ave, Bronx, NY 10465-2422 | 2020-02-07 |
| 1639735483 | Ajs Brooklyn Medical Practice PC | Clinic/Center | 655 Morris Ave # 2, Bronx, NY 10451-4898 | 2019-05-17 |
| 1700340437 | Virginia Martinez Md PC | Clinic/Center | 1749a Grand Concourse Ofc A, Bronx, NY 10453-8202 | 2019-01-28 |
| 1811412554 | Montefiore Medical Center | Clinic/Center | 1250 Waters Pl Ste 1201, Bronx, NY 10461-2735 | 2017-08-03 |
| 1801331392 | Hector R Rodriguez Navarro Md | Clinic/Center | 1025 Grand Concourse, Bronx, NY 10452-9107 | 2016-12-20 |
| 1982060240 | Sandra Akakpo | Clinic/Center | 1987 Bathgate Ave Apt 1, Bronx, NY 10457-4406 | 2016-01-02 |
| 1477829588 | Respiro Inc. | Clinic/Center | 837 Neill Ave, Apt. 2, Bronx, NY 10462-3042 | 2012-03-23 |
| 1376810010 | Montefiore Medical Center | Clinic/Center | 730 Concourse Village West, Bronx, NY 10451 | 2011-11-23 |
| 1396050290 | D.f.s Pulle Physician PC | Clinic/Center | 2410 Barker Ave, Suite 1g, Bronx, NY 10467-7629 | 2010-08-16 |
| 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.