BRONXCARE OGDEN FAMILY MEDICAL & DENTAL CENTER
NPI 1740558568
Clinic/Center - Federally Qualified Health Center (FQHC) in Bronx, NY

Q: What is Bronxcare Dr. Martin Luther King Jr. Health Center's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

Active since December 07, 2011CLIA 33D1075766 · Waiver

1067 OGDEN AVE, BRONX, NY 10452(718) 901-8600(718) 293-1475 Get Directions Write a Review

NPPES record last updated: June 28, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Bronxcare Ogden Family Medical & Dental Center NPPES

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

BRONXCARE OGDEN FAMILY MEDICAL & DENTAL CENTER (NPI 1740558568) is a healthcare organization registered as a federally qualified health center (fqhc) in Bronx, New York and active in the NPI registry since December 2011. The organization holds a CLIA Waiver certificate valid through March 26, 2027 and lists Victor G Demarco, Senior Vp-chief Financial Officer, as its authorized official.

NPPES Registry Identity

NPI1740558568

Entity TypeOrganization

Primary Taxonomy261QF0400X

Legal Business NameBRONXCARE DR. MARTIN LUTHER KING JR. HEALTH CENTER

Location Address1067 OGDEN AVEBronx, NY 10452

Mailing Address1276 Fulton AveBronx, NY 10456-3402 · (718) 901-8600 · Fax (718) 293-1475

Phone(718) 901-8600

Fax(718) 293-1475

Organization SubpartYesParent: Bronxcare Dr. Martin Luther King Jr Health Center Inc

Authorized OfficialVictor G DemarcoSenior Vp-chief Financial Officer · (718) 901-8600

Enumeration DateDecember 7, 2011

Last NPPES UpdateJune 28, 2018

✔ NPI 1740558568 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities

Taxonomy Code261QF0400X

License✔ Licensed in NY · 7000212R

1067 OGDEN AVE, Bronx, NY 10452

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Other Names 1

Doing Business AsBronxcare Ogden Family Medical & Dental Center

Other Identifiers 2

OtherW0437NY · Blue Cross

Medicaid00244573NY

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 33D1075766

Bronx Care Ogden Family Medical And Dental Center · Bronx, NY

Active · expires Mar 26, 2027

CLIA Number33D1075766

Laboratory TypeCommunity Clinic

Certificate Effective DateOctober 29, 2007

Certificate Expiration DateMarch 26, 2027

Laboratory DirectorDr. Aam A. Baqui

Laboratory Phone(718) 466-3255

Laboratory LocationBronx Care Ogden Family Medical And Dental Center1067 Ogden Avenue, Bronx, NY 10452

CLIA data matches this NPI record on: Address

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

Other Providers at the Same Location NPPES 5

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

DR. RUBI MODESTO VALERIO MD.

Family Medicine