Provider Demographics
NPI:1790964476
Name:MARIA BRIONES MD PC
Entity Type:Organization
Organization Name:MARIA BRIONES MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:DOLORES
Authorized Official - Last Name:BRIONES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-238-0190
Mailing Address - Street 1:41 S BEDFORD RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-3407
Mailing Address - Country:US
Mailing Address - Phone:914-238-0190
Mailing Address - Fax:914-407-1582
Practice Address - Street 1:41 S BEDFORD RD
Practice Address - Street 2:
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-3407
Practice Address - Country:US
Practice Address - Phone:914-238-0190
Practice Address - Fax:914-407-1582
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-30
Last Update Date:2007-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY196119261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG05038Medicare UPIN