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Organization

BANG AWARENESS ALCOHOL PREVENTION

Active
Other names
McConneghey Bang & Corp Inc
Organization subpart
No

Provider details

NPI number
Authorized official
PROF. MARITZA MCCONNEGHEY HHS LPN (CHIEF EXEC OFFICER)
(917) 239-5729
Entity
Organization

Contact information

Practice address
1075 UNIVERSITY AVE, STADIUM STATION 524525, BRONX, NY 10452
(347) 220-7578
Mailing address
1138 E 229TH ST DRIVE SOUTH AVE, 6G, BRONX, NY 10466
(917) 239-5729

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
I069
NY
261QC1500X
Community Health Clinic/Center
5292
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02799640
NM
Enumeration date
06/22/2006
Last updated
09/11/2025
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