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CCN GENERAL MEDICINE PLLC
NPI 1902120025
Clinic/Center - Primary Care in Bronx, NY

Active since March 18, 2010CLIA 33D2009552 · Waiver
1262 BOSTON RD, SUITE 2, BRONX, NY 10456(718) 569-7929(347) 590-5482 Get Directions Write a Review

NPPES record last updated: March 23, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 23, 2026, Jun 19, 2025 (2 updates tracked since 2025).

About Ccn General Medicine Pllc NPPES

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

CCN GENERAL MEDICINE PLLC (NPI 1902120025) is a healthcare organization registered as a primary care in Bronx, New York and active in the NPI registry since March 2010. The organization holds a CLIA Waiver certificate valid through July 6, 2028 and lists Hector D Reyes, Adm, as its authorized official.

NPPES Registry Identity

NPI1902120025
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameCCN GENERAL MEDICINE PLLC
Location Address1262 BOSTON RD, SUITE 2Bronx, NY 10456-3602
Mailing Address1262 Boston Rd, Suite 2Bronx, NY 10456-3602 · (718) 569-7929
Phone(718) 569-7929
Fax(347) 590-5482
Organization SubpartNo
Authorized OfficialHector D ReyesAdm · (718) 569-7929
Enumeration DateMarch 18, 2010
Last NPPES UpdateMarch 23, 20262 updates tracked since enumeration
NPPES CertifiedMarch 23, 2026
✔ NPI 1902120025 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
License✔ Licensed in NY · 255626
Also ListedFamily MedicineTaxonomy 207Q00000X
Also ListedInternal MedicineTaxonomy 207R00000X
1262 BOSTON RD, Bronx, NY 10456
Open in Google Maps ↗

Other Identifiers 2

Medicaid02932589NY
Other1427118140NY · Npi

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

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 33D2009552

Ccn General Medicine PLLC · Bronx, NY
Active · expires Jul 6, 2028
CLIA Number33D2009552
Laboratory TypePhysician Office
Certificate Effective DateJuly 7, 2026
Certificate Expiration DateJuly 6, 2028
Laboratory DirectorDr. Cecilia G. Calderon
Laboratory Phone(718) 569-7929
Laboratory LocationCcn General Medicine PLLC1262 Boston Road Suite 2, Bronx, NY 10456
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 16

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

BOSTON PEDIATRICS PLLC
Nurse Practitioner
1262 BOSTON RD
BRONX, NY 10456
Bronx County (718) 617-2500
DR. HANNY MERCEDES HERNANDEZ D.P.M
Podiatrist (Foot & Ankle Surgery)
1262 BOSTON RD
BRONX, NY 10456
Bronx County (347) 862-9092
ESTEFANY YANERYS MORILLO TAMAYO M.D
Pediatrics
1262 BOSTON RD, SUITE 1
BRONX, NY 10456
Bronx County (718) 617-2500
DR. JORGE LUIS CORNIELLE MD
Pediatrics
1262 BOSTON RD
BRONX, NY 10456
Bronx County (718) 617-2500
MARCIA PEHR DO
Emergency Medicine
1262 BOSTON RD, SUITE 2
BRONX, NY 10456
Bronx County (718) 569-7929
BOSTON PEDIATRICS, PLLC
Pediatrics
1262 BOSTON RD, SUITE 1
BRONX, NY 10456
Bronx County (718) 617-2500
MS. ROMY G FABAL FNP
Nurse Practitioner (Family)
1262 BOSTON RD
BRONX, NY 10456
Bronx County (718) 617-2500
HEART OF NY CARDIOLOGY, PC
Internal Medicine (Interventional Cardiology)
1262 BOSTON RD
BRONX, NY 10456
Bronx County (917) 991-7563

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ccn General Medicine PLLC's NPI number?

The NPI number for Ccn General Medicine PLLC is 1902120025. It was assigned to this organization in the NPPES registry on March 18, 2010.

Where is Ccn General Medicine PLLC located?

Ccn General Medicine PLLC is located at 1262 Boston Rd Suite 2, Bronx, NY 10456. The listed phone number is (718) 569-7929.

What is Ccn General Medicine PLLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Does Ccn General Medicine PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D2009552) is associated with this NPI, valid through July 6, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Ccn General Medicine PLLC was last updated on March 23, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.