# 334 MEDICAL PC

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

## Provider details

- **NPI number:** 1982968939
- **Authorized official:** DEAN BASULTO (M.D)
- **Authorized official phone:** (718) 993-0200

## Contact information

- **Practice address:** 334 GRAND CONCOURSE, BRONX, NY 10451-5409
- **Practice address phone:** (718) 993-0200
- **Practice address fax:** (718) 993-0204
- **Mailing address:** 334 GRAND CONCOURSE, BRONX, NY 10451-5409
- **Mailing address phone:** (718) 993-0200
- **Mailing address fax:** (718) 993-0204

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 205919 | NY | Yes |

## Other

- **Enumeration date:** 06/25/2012
- **Last updated:** 06/25/2012