Provider Demographics
NPI:1508947763
Name:TOTAL CARE FAMILY PRACTICE PC
Entity Type:Organization
Organization Name:TOTAL CARE FAMILY PRACTICE PC
Other - Org Name:EMANCIA P NEIL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EMANCIA
Authorized Official - Middle Name:
Authorized Official - Last Name:NEIL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-466-0430
Mailing Address - Street 1:1571 SHERIDAN AVE
Mailing Address - Street 2:SUITE 4B
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457-8546
Mailing Address - Country:US
Mailing Address - Phone:718-466-0430
Mailing Address - Fax:
Practice Address - Street 1:1571 SHERIDAN AVE
Practice Address - Street 2:SUITE 4B
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-8546
Practice Address - Country:US
Practice Address - Phone:718-466-0430
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2014-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY211252174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty