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 established in Bronx, New York specializing in clinic/center. The NPI number of Mmc Medical Park At 1635 Poplar is 1003000779 and was assigned on September 2007. The practitioner's primary taxonomy code is 261QP2300X with license number 7000006H (NY). The provider is registered as an organization and their NPI record was last updated 12 years ago.
The authorized official of this NPI record is Michael G Dowling (Director)
| NPI | 1003000779 |
| Provider Name | MMC MEDICAL PARK AT 1635 POPLAR |
| Provider Location Address | MMC MEDICAL PARK AT 1635 POPLAR 1635 POPLAR STREET BRONX, NY 10461 |
| Provider Mailing Address | CMO 100 CORPORATE DRIVE YONKERS, NY 10701 |
| NPI Entity Type | Organization |
| Is Sole Proprietor? | N/A |
| Is Organization Subpart? | Yes |
| Enumeration Date | 09-05-2007 |
| Last Update Date | 09-05-2007 |
Primary Taxonomy
| Taxonomy Code | 261QP2300X |
| 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
Mailing Address
MMC MEDICAL PARK AT 1635 POPLAR
CMO
100 CORPORATE DRIVE
YONKERS, NY
ZIP 10701
Phone: (914) 377-4722
NPI Footnotes
What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
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
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type 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)
What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart 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.
Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.
Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date
The date that a NPI record was last updated or changed.
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.
Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.