Organization
BRONX MODERN MEDICAL. PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAY C MIRANDA MD (OWNER)
(718) 676-4600
Entity
Organization
Contact information
Practice address
446 EAST 149TH STREET, BRONX, NY 10455-1200
(718) 676-4600
(718) 676-4603
Mailing address
446 EAST 149TH STREET, BRONX, NY 10455-1200
(718) 676-4600
(718) 676-4603
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
217149
NY
Other
Enumeration date
07/26/2010
Last updated
07/26/2010
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