# BRONXLEBAON HOSPITAL

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

## Provider details

- **NPI number:** 1649437021
- **Authorized official:** DR. MARIO LUIS VASQUEZ MD (MD)
- **Authorized official phone:** (718) 901-8294

## Contact information

- **Practice address:** 1770 GRAND CONCOURSE, DEP 5L1, BRONX, NY 10457-5524
- **Practice address phone:** (718) 901-8294
- **Mailing address:** 1770 GRAND CONCOURSE, DEP 5L1, BRONX, NY 10457-5524

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 282N00000X | General Acute Care Hospital | — | NULL | Yes |

## Other

- **Enumeration date:** 05/22/2008
- **Last updated:** 05/22/2008