Organization
THE PAC PROGRAM OF THE BRONX
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ZEEV BANNETT (CFO)
(908) 705-4902
Entity
Organization
Contact information
Practice address
1215 STRATFORD AVE, BRONX, NY 10472-2501
(718) 328-2605
(718) 328-2609
Mailing address
1215 STRATFORD AVE, BRONX, NY 10472-2501
(718) 328-2605
(718) 328-2609
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
100411691
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100411691
NEW YORK STATE OPERATING CERTIFICATE
NY
Enumeration date
06/05/2009
Last updated
01/21/2026
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