| Cedi Medical Office Pllc | |
|
2940 Grand Concourse Unit 1a-1b Bronx NY 10458-2611 | |
| (718) 220-0900 | |
| (718) 733-6773 |
| Full Name | Cedi Medical Office Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 2940 Grand Concourse Unit 1a-1b, Bronx, New York |
| Authorized Official Name and Position | Kwabena Boakye (MEDICAL DIRECTOR) |
| Authorized Official Contact | 7182200900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cedi Medical Office Pllc 2940 Grand Concourse Unit 1a-1b Bronx NY 10458-2611 Ph: (718) 220-0900 | Cedi Medical Office Pllc 2940 Grand Concourse Unit 1a-1b Bronx NY 10458-2611 Ph: (718) 220-0900 |
| NPI Number | 1992310411 |
|---|---|
| Provider Enumeration Date | 09/11/2020 |
| Last Update Date | 04/30/2021 |
| Medicare PECOS PAC ID | 4688078629 |
|---|---|
| Medicare Enrollment ID | O20210812001628 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992310411 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| Provider Name | Kwabena Boakye |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073745659 PECOS PAC ID: 3678720596 Enrollment ID: I20120829000218 |
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