Organization
DIVINITY PHYSICIAN SERVICES PLLC
Active
Other names
AFC Primary Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAJESH GUPTA M.D (MEDICAL DIRECTOR)
(914) 844-9803
Entity
Organization
Contact information
Practice address
332 E 149TH ST, BRONX, NY 10451-5606
(347) 329-4010
(347) 329-4009
Mailing address
332 E 149TH ST, BRONX, NY 10451-5606
(347) 329-4010
(347) 329-4009
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
04/05/2017
Last updated
08/14/2023
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