Provider Demographics
NPI:1497956544
Name:ATAC MEDICAL CARE PC
Entity Type:Organization
Organization Name:ATAC MEDICAL CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BULENT
Authorized Official - Middle Name:SADIK
Authorized Official - Last Name:ATAC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-881-2716
Mailing Address - Street 1:1619 PELHAM PKWY N
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10469-6416
Mailing Address - Country:US
Mailing Address - Phone:718-881-2716
Mailing Address - Fax:718-708-7790
Practice Address - Street 1:1619 PELHAM PKWY N
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469-6416
Practice Address - Country:US
Practice Address - Phone:718-881-2716
Practice Address - Fax:718-708-7790
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY180769261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care