Boston Road Medical Practice Pc

LBN: Boston Road Medical Practice Pc
Boston Road Medical Practice Pc is an health care organization with primary practice located at 2190 Boston Rd Suite 1N, Bronx NY 10462-1201. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as the primary health care specialty. Boston Road Medical Practice Pc can be contacted via phone (718) 863-8663, or through Kazakov, Valeri via phone (718) 863-8663.

Contact Information

Primary practice address
2190 Boston Rd Suite 1N Bronx NY 10462-1201
Phone: (718) 863-8663
Fax: (718) 863-8261
Website:
Map and Directions
Authorized official contact:
Name: Kazakov, Valeri Doctor of Medicine (MD)
Phone: (718) 863-8663

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X

Profile Details

NPI number 1306816285
LBN Legal business name Boston Road Medical Practice Pc
DBA Doing business as
Authorized official Kazakov, Valeri Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jan 24th, 2006
Last updated Sep 7th, 2010 - about 14 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1306816285 NPPES
New York MEDICAID 023196

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