Provider Demographics
NPI:1700275344
Name:BRONXCARE HEALTH SYSTEM
Entity Type:Organization
Organization Name:BRONXCARE HEALTH SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO/SVP
Authorized Official - Prefix:
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:DEMARCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-901-8600
Mailing Address - Street 1:1284 SPRING CREEK DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37209-5152
Mailing Address - Country:US
Mailing Address - Phone:615-484-7202
Mailing Address - Fax:
Practice Address - Street 1:1284 SPRING CREEK DR
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37209
Practice Address - Country:US
Practice Address - Phone:615-484-7202
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-20
Last Update Date:2018-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental