Provider Demographics
NPI:1417027558
Name:BRONXCARE HEALTH SYSTEM
Entity Type:Organization
Organization Name:BRONXCARE HEALTH SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR VP- CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:G
Authorized Official - Last Name:DEMARCO
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:718-901-8600
Mailing Address - Street 1:1276 FULTON AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10456-3402
Mailing Address - Country:US
Mailing Address - Phone:718-901-8600
Mailing Address - Fax:718-293-1475
Practice Address - Street 1:1650 GRAND CONCOURSE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457
Practice Address - Country:US
Practice Address - Phone:718-901-8600
Practice Address - Fax:718-293-1475
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7000001H282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000083NOtherBLUE CROSS
NY00476022Medicaid
NY00476022Medicaid