MMC MEDICAL PARK AT 1635 POPLAR NPI 1003000779

Clinic/Center (Primary Care) in Bronx, NY

About MMC MEDICAL PARK AT 1635 POPLAR

Mmc Medical Park At 1635 Poplar is a provider in Bronx, NY. The NPI number assigned to this provider is 1003000779. The practitioner's primary taxonomy code is Clinic/Center (261QP2300X). The provider is registered as an organization and their NPI record was last updated 10 years ago.

NPI1003000779 Additional informationCallout TooltipNational Provider Indentifier (NPI)
The 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider NameMMC MEDICAL PARK AT 1635 POPLAR
Provider Location AddressMMC MEDICAL PARK AT 1635 POPLAR 1635 POPLAR STREET BRONX, NY 10461 Additional informationCallout TooltipProvider location address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing AddressCMO 100 CORPORATE DRIVE YONKERS, NY 10701 Additional informationCallout TooltipProvider mailing address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
NPI Entity TypeOrganization Additional informationCallout TooltipEntity type code
The code describing the type of health care provider that is being assigned an NPI.
Codes are:
1 = (Person): individual human being who furnishes health care;
2 = (Non-person): entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO).
Is Sole Proprietor?N/A
Is Organization Subpart?Yes Additional informationCallout TooltipWhat is a subpart?
Subparts are the components and separate physical locations of organization health care providers. Examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Enumeration Date09-05-2007 Additional informationCallout TooltipProvider enumeration date
The date the provider was assigned a unique identifier (assigned an NPI)
Last Update Date09-05-2007 Additional informationCallout TooltipLast update date
The date that a record was last updated or changed.

Business Address

MMC MEDICAL PARK AT 1635 POPLAR
MMC MEDICAL PARK AT 1635 POPLAR
1635 POPLAR STREET
BRONX, NY
ZIP 10461
Phone: (914) 377-4722
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Mailing Address

MMC MEDICAL PARK AT 1635 POPLAR
CMO
100 CORPORATE DRIVE
YONKERS, NY
ZIP 10701
Phone: (914) 377-4722

Primary Taxonomy

Taxonomy Code261QP2300X Additional informationCallout TooltipPrimary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
ClassificationClinic/Center
TypeAmbulatory Health Care Facilities
SpecializationPrimary Care
License No.7000006H
License StateNY

Authorized Official

Authorized Official Name MICHAEL G DOWLING Additional informationCallout TooltipAuthorized official name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.
Authorized Official TitleDIRECTOR
Authorized Official Phone(914) 377-4668

Map Location


MMC MEDICAL PARK AT 1635 POPLAR address is MMC MEDICAL PARK AT 1635 POPLAR 1635 POPLAR STREET BRONX, NY 10461