Provider Demographics
NPI:1568047041
Name:PONTO CARE INC.
Entity Type:Organization
Organization Name:PONTO CARE INC.
Other - Org Name:PONTO CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:FABIO
Authorized Official - Middle Name:A
Authorized Official - Last Name:THIERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD, MSC
Authorized Official - Phone:617-365-2222
Mailing Address - Street 1:19 MORRIS AVE BLDG 128
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11205-1095
Mailing Address - Country:US
Mailing Address - Phone:617-365-2222
Mailing Address - Fax:
Practice Address - Street 1:19 MORRIS AVE BLDG 128
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11205-1095
Practice Address - Country:US
Practice Address - Phone:617-365-2222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-16
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
No293D00000XLaboratoriesPhysiological Laboratory