# GRAND CONCOURSE MEDICAL PRACTICE, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265744197
- **Authorized official:** MANUEL ELIGIO MEJIA MD (OWNER)
- **Authorized official phone:** (347) 577-5804

## Contact information

- **Practice address:** 1831 GRAND CONCOURSE FRNT A, BRONX, NY 10453-6324
- **Practice address phone:** (646) 640-6246
- **Mailing address:** 1831 GRAND CONCOURSE FRNT A, BRONX, NY 10453-6324
- **Mailing address phone:** (646) 640-6246

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 241121 | NY | Yes |

## Other

- **Enumeration date:** 07/08/2010
- **Last updated:** 08/20/2026