| Bang Awareness Alcohol Prevention | |
|
1075 University Ave Stadium Station 524525 Bronx NY 10452 | |
| (347) 220-7578 | |
| Not Available |
| Full Name | Bang Awareness Alcohol Prevention |
|---|---|
| Speciality | Licensed Practical Nurse |
| Location | 1075 University Ave, Bronx, New York |
| Authorized Official Name and Position | Maritza Mcconneghey (CHIEF EXEC OFFICER) |
| Authorized Official Contact | 9172395729 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bang Awareness Alcohol Prevention 1138 E 229th St Drive South Ave 6g Bronx NY 10466 Ph: (917) 239-5729 | Bang Awareness Alcohol Prevention 1075 University Ave Stadium Station 524525 Bronx NY 10452 Ph: (347) 220-7578 |
| NPI Number | 1770529026 |
|---|---|
| Provider Enumeration Date | 06/22/2006 |
| Last Update Date | 09/11/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770529026 | NPI | - | NPPES |
| 02799640 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | 5292 (New York) | Secondary |
| 164W00000X | Licensed Practical Nurse | I069 (New York) | Primary |
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