Basic Information
| Provider Information | |||||||||
| NPI: | 1407818867 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BRONX PARK PULMONARY MEDICINE,PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2016 BRONXDALE AVE | ||||||||
| Address2: | SUITE 301 | ||||||||
| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 104623388 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7184092222 | ||||||||
| FaxNumber: | 7189181301 | ||||||||
| Practice Location | |||||||||
| Address1: | 2016 BRONXDALE AVE | ||||||||
| Address2: | SUITE 301 | ||||||||
| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 104623388 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7184092222 | ||||||||
| FaxNumber: | 7189181301 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/03/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | SENDER | ||||||||
| AuthorizedOfficialFirstName: | JOEL | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7184092222 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | 132978 | NY | Y | 193400000X SINGLE SPECIALTY GROUP | Other Service Providers | Specialist |
No ID Information.