Provider Demographics
NPI:1659539476
Name:BRONXVILLE MEDICAL ASSOCIATES, PLLC
Entity Type:Organization
Organization Name:BRONXVILLE MEDICAL ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CONTILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-668-7333
Mailing Address - Street 1:559 GRAMATAN AVE
Mailing Address - Street 2:STE 210
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10552-2155
Mailing Address - Country:US
Mailing Address - Phone:914-668-7333
Mailing Address - Fax:914-668-7410
Practice Address - Street 1:559 GRAMATAN AVE
Practice Address - Street 2:STE 210
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10552-2155
Practice Address - Country:US
Practice Address - Phone:914-668-7333
Practice Address - Fax:914-668-7410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-29
Last Update Date:2009-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty