# MCC-NY

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** BOP
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1275808669
- **Legal business name:** BOP
- **Authorized official:** ANTHONY BUSSANICH (MD)
- **Authorized official phone:** (646) 836-6428

## Contact information

- **Practice address:** 150 PARK ROW, NYC, NY 10007
- **Practice address phone:** (646) 836-6428
- **Mailing address:** 203 N.16 STREET, 2ND FLOOR, BLOOMFIELD, NJ 07003
- **Mailing address phone:** (973) 968-1409

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2400X | Prison Health Clinic/Center | — | NY | Yes |

## Other

- **Enumeration date:** 03/19/2012
- **Last updated:** 03/19/2012