Organization
BRONXCARE DR. MARTIN LUTHER KING JR. HEALTH CENTER
Active
Organization
BRONXCARE DR. MARTIN LUTHER KING JR. HEALTH CENTER
Active
Parent organization
BRONXCARE DR MARTIN LUTHER KING JR HEALTH CENTER INC
Other names
Bronxcare 174th St Medical Practice, BronxCare MBD Family Practice
Organization subpart
Yes
Provider details
NPI number
Legal business name
BRONXCARE DR MARTIN LUTHER KING JR HEALTH CENTER INC
Authorized official
VICTOR GEORGE DEMARCO (SVP CFO)
(718) 901-8600
Entity
Organization
Contact information
Practice address
961 E 174TH ST, BRONX, NY 10460-5060
(718) 992-7669
Mailing address
1276 FULTON AVE, BRONX, NY 10456-3467
(718) 901-8600
(718) 293-1475
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
7000212R
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03410928
—
NY
Enumeration date
03/09/2011
Last updated
09/26/2025
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