Provider Demographics
NPI:1629313945
Name:BRONXCARE HEALTH SYSTEM
Entity Type:Organization
Organization Name:BRONXCARE HEALTH SYSTEM
Other - Org Name:GI
Other - Org Type:Other Name
Authorized Official - Title/Position:SVR/CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:DEMARCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-901-8600
Mailing Address - Street 1:1276 FULTON AVE
Mailing Address - Street 2:ROOM 208
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10456-3402
Mailing Address - Country:US
Mailing Address - Phone:718-901-8918
Mailing Address - Fax:
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:718-901-8918
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BRONXCARE HEALTH SYSTEM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-11-28
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty