Organization
UNITED STATES MARINE CORPS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ERWIN MEMBRENO (MILITARY)
(718) 938-0696
Entity
Organization
Contact information
Practice address
2488 GRAND CONCOURSE RM 204, BRONX, NY 10458-5207
(718) 938-0696
(718) 367-6212
Mailing address
2488 GRAND CONCOURSE RM 204, BRONX, NY 10458-5207
(718) 938-0696
(718) 367-6212
Taxonomy
Speciality
Code
Description
License number
State
286500000X
Military Hospital
Primary
—
—
Other
Enumeration date
05/26/2011
Last updated
05/26/2011
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