Organization
1211 WPR MEDICAL SERVICES PC
Active
Parent organization
1211 WPR MEDICAL PC
Other names
Westchester Medical HealthCare, Parkchester Medical Services of NY, PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
1211 WPR MEDICAL PC
Authorized official
AMY CAROL POLAN (AM)
(718) 828-6610
Entity
Organization
Contact information
Practice address
1211 WHITE PLAINS RD, BRONX, NY 10472-4900
(718) 082-8066
(718) 829-9132
Mailing address
1211 WHITE PLAINS RD, BRONX, NY 10472-4900
(718) 828-6610
(718) 829-9132
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
207RC0000X
Cardiovascular Disease Physician
0810561
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02770029
—
NY
Enumeration date
10/11/2006
Last updated
08/30/2021
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