PERRY AVE FAMILY MEDICAL CENTER INC - NPI 1619973518

Q: What is Perry Ave Family Medical Center Inc's NPI number?

The NPI number for Perry Ave Family Medical Center Inc is 1619973518. It was assigned to this organization in the NPPES registry on June 24, 2005.

Q: What is Perry Ave Family Medical Center Inc's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

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About Perry Ave Family Medical Center Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PERRY AVE FAMILY MEDICAL CENTER INC (NPI 1619973518) is a healthcare organization registered as a family medicine in Bronx, New York and active in the NPI registry since June 2005. The organization holds a CLIA Waiver certificate valid through March 26, 2027 and lists Shama R Khan, Operations Manager, as its authorized official.

NPPES Registry Identity

NPI1619973518

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NamePERRY AVE FAMILY MEDICAL CENTER INC

Location Address3071 PERRY AVEBronx, NY 10467-4111

Mailing Address3071 Perry AveBronx, NY 10467-4111 · (718) 231-6700 · Fax (718) 515-5454

Phone(718) 231-6700

Fax(718) 515-5454

Organization SubpartNo

Authorized OfficialShama R KhanOperations Manager · (718) 231-6700

Enumeration DateJune 24, 2005

Last NPPES UpdateJuly 8, 2015

✔ NPI 1619973518 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Also ListedAllergy & Immunology · AllergyTaxonomy 207KA0200X

Also ListedInternal MedicineTaxonomy 207R00000X

Also ListedObstetrics & GynecologyTaxonomy 207V00000X

Also ListedPediatricsTaxonomy 208000000X

3071 PERRY AVE, Bronx, NY 10467

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Other Identifiers 6

Other2478450NY · United Health Care

Medicaid02444553NY

Other041227000012NY · Fidelis

Other7829562NY · Aetna

Other2000416NY · Ghi

OtherS70F11NY · Blue Cross

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Louisiana, Blue Cross Blue Shield of Wyoming.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 33D2277450

Perry Avenue Family Medical Center Inc · Bronx, NY

Active · expires Mar 26, 2027

CLIA Number33D2277450

Laboratory TypeCommunity Clinic

Certificate Effective DateFebruary 28, 2023

Certificate Expiration DateMarch 26, 2027

Laboratory DirectorDr. Abdalla Adam

Laboratory Phone(718) 231-6700

Laboratory LocationPerry Avenue Family Medical Center Inc3071 Perry Ave, Bronx, NY 10467

CLIA data matches this NPI record on: Address Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NEHALBEN G. SAKHARELIYA FNP

Nurse Practitioner (Family)