Organization
BRONX MEDICAL SERVICES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OKON E UMANA MD (MEDICAL DIRECTOR)
(718) 537-3392
Entity
Organization
Contact information
Practice address
930 GRAND CONCOURSE, BRONX, NY 10451-2705
(718) 537-3392
Mailing address
100 LINN AVE, YONKERS, NY 10705-2503
(914) 751-5900
(914) 965-1974
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
153743
NY
261QC1500X
Community Health Clinic/Center
153743
NY
261QH0100X
Health Service Clinic/Center
153743
NY
261QM1300X
Multi-Specialty Clinic/Center
153743
NY
261QP2000X
Physical Therapy Clinic/Center
153743
NY
261QP2300X
Primary Care Clinic/Center
153743
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00758190
—
NY
01
—
90D672
BCBS
NY
Enumeration date
08/11/2007
Last updated
04/20/2008
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