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 11 years ago.

NPI	1003000779 National Provider Indentifier (NPI) The 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider Name	MMC MEDICAL PARK AT 1635 POPLAR
Provider Location Address	MMC MEDICAL PARK AT 1635 POPLAR 1635 POPLAR STREET BRONX, NY 10461 Provider 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 Address	CMO 100 CORPORATE DRIVE YONKERS, NY 10701 Provider mailing address The mailing address of the provider being identified. This address may contain the same information as the provider location address.
NPI Entity Type	Organization Entity 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 What 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 Date	09-05-2007 Provider enumeration date The date the provider was assigned a unique identifier (assigned an NPI)
Last Update Date	09-05-2007 Last update date The date that a record was last updated or changed.

Primary Taxonomy

Taxonomy Code	261QP2300X Primary 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.
Classification	Clinic/Center
Type	Ambulatory Health Care Facilities
Specialization	Primary Care
License No.	7000006H
License State	NY

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

Authorized Official

Authorized Official Name	MICHAEL G DOWLING Authorized 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 Title	DIRECTOR
Authorized Official Phone	(914) 377-4668

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