Organization
GRAND CONCOURSE MEDICAL PRACTICE, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MANUEL E MEJIA MD (MEDICAL DIRECTOR)
(646) 640-6246
Entity
Organization
Contact information
Practice address
1831 GRAND CONCOURSE STE A, BRONX, NY 10453-6324
(646) 640-6246
Mailing address
1831 GRAND CONCOURSE STE A, BRONX, NY 10453-6324
(646) 640-6246
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
241121
NY
Other
Enumeration date
07/08/2010
Last updated
10/21/2016
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