| Morris Heights Health Center, Inc. | |
| 
					85 W Burnside Ave Bronx NY 10453-4015  | |
| (718) 716-4400 | |
| Not Available | 
| Full Name | Morris Heights Health Center, Inc. | 
|---|---|
| Speciality | Clinic/Center | 
| Location | 85 W Burnside Ave, Bronx, New York | 
| Authorized Official Name and Position | Lourdes Clemente (SR. MANAGER, REVENUE CYCLE) | 
| Authorized Official Contact | 7187164400 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Morris Heights Health Center, Inc. 85 W Burnside Ave Bronx NY 10453-4015 Ph: (718) 483-1270  | Morris Heights Health Center, Inc. 85 W Burnside Ave Bronx NY 10453-4015 Ph: (718) 716-4400  | 
| NPI Number | 1184694291 | 
|---|---|
| Provider Enumeration Date | 01/23/2006 | 
| Last Update Date | 12/13/2024 | 
| Medicare PECOS PAC ID | 3072798172 | 
|---|---|
| Medicare Enrollment ID | O20110505000508 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1184694291 | NPI | - | NPPES | 
| 00590390 | Medicaid | NY | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 7000236R (New York) | Primary | 
| Provider Name | Jason Hodges | 
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology | 
| Provider Identifiers | NPI Number: 1306828744 PECOS PAC ID: 9234033390 Enrollment ID: I20031121000082  | 
| Provider Name | Stephen H Robinson | 
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology | 
| Provider Identifiers | NPI Number: 1770566580 PECOS PAC ID: 9133016686 Enrollment ID: I20040301000732  | 
| Provider Name | Edmond Balakhane | 
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology | 
| Provider Identifiers | NPI Number: 1992787121 PECOS PAC ID: 3577450717 Enrollment ID: I20040302000717  | 
| Provider Name | Alexander Alerte | 
|---|---|
| Provider Type | Practitioner - Psychiatry | 
| Provider Identifiers | NPI Number: 1275609935 PECOS PAC ID: 3971495219 Enrollment ID: I20040330000059  | 
| Provider Name | Walter M Ralph | 
|---|---|
| Provider Type | Practitioner - Otolaryngology | 
| Provider Identifiers | NPI Number: 1013983097 PECOS PAC ID: 2163416348 Enrollment ID: I20040412000549  | 
| Provider Name | Nadia Marsh | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1811936834 PECOS PAC ID: 0345234217 Enrollment ID: I20040413001026  | 
| Provider Name | Carl Guillaume | 
|---|---|
| Provider Type | Practitioner - Gastroenterology | 
| Provider Identifiers | NPI Number: 1528098118 PECOS PAC ID: 2264421973 Enrollment ID: I20040508000059  | 
| Provider Name | David I Weltman | 
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology | 
| Provider Identifiers | NPI Number: 1326021163 PECOS PAC ID: 4880684687 Enrollment ID: I20040513001529  | 
| Provider Name | Robert M Wilkins | 
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology | 
| Provider Identifiers | NPI Number: 1508840505 PECOS PAC ID: 8224029459 Enrollment ID: I20040518001207  | 
| Provider Name | Russell S Weinstein | 
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology | 
| Provider Identifiers | NPI Number: 1992788459 PECOS PAC ID: 4587641261 Enrollment ID: I20040630001019  | 
| Provider Name | Alfred M Fiad | 
|---|---|
| Provider Type | Practitioner - Psychiatry | 
| Provider Identifiers | NPI Number: 1407896210 PECOS PAC ID: 7012982705 Enrollment ID: I20040826001148  | 
| Provider Name | Jonathan E Lerner | 
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology | 
| Provider Identifiers | NPI Number: 1346297645 PECOS PAC ID: 7315851904 Enrollment ID: I20041111000070  | 
| Provider Name | Michael Joseph Benanti | 
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology | 
| Provider Identifiers | NPI Number: 1619945342 PECOS PAC ID: 7911964853 Enrollment ID: I20041213000763  | 
| Provider Name | Tammy R Gruenberg | 
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology | 
| Provider Identifiers | NPI Number: 1205994324 PECOS PAC ID: 2466419197 Enrollment ID: I20041214001252  | 
| Provider Name | Heidi N Kolman | 
|---|---|
| Provider Type | Practitioner - Clinical Social Worker | 
| Provider Identifiers | NPI Number: 1881629905 PECOS PAC ID: 4486669538 Enrollment ID: I20060213000004  | 
| Provider Name | Daniel R Pilosov | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1013092006 PECOS PAC ID: 2466468244 Enrollment ID: I20060303000005  | 
| Provider Name | Kenneth O Jones | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1730139262 PECOS PAC ID: 2860409166 Enrollment ID: I20060310000637  | 
| Provider Name | Assumpta A Madu | 
|---|---|
| Provider Type | Practitioner - Ophthalmology | 
| Provider Identifiers | NPI Number: 1174604508 PECOS PAC ID: 9133224694 Enrollment ID: I20070412000255  | 
| Provider Name | Marcia R. Robinson | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1891855276 PECOS PAC ID: 7315044138 Enrollment ID: I20070512000032  | 
| Provider Name | Steven I. Leffler | 
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology | 
| Provider Identifiers | NPI Number: 1326056995 PECOS PAC ID: 9436117090 Enrollment ID: I20071109000097  | 
| Provider Name | Gary Kronfeld | 
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology | 
| Provider Identifiers | NPI Number: 1063526630 PECOS PAC ID: 0042119380 Enrollment ID: I20081120000337  | 
| Provider Name | Donna M Alfieri | 
|---|---|
| Provider Type | Practitioner - Podiatry | 
| Provider Identifiers | NPI Number: 1457324493 PECOS PAC ID: 1052477023 Enrollment ID: I20090227000359  | 
| Provider Name | Jordan Golubcow Teglasi | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1043479603 PECOS PAC ID: 9335296078 Enrollment ID: I20090415000060  | 
| Provider Name | Emmanuel N Rodriguez | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1497856728 PECOS PAC ID: 9830160704 Enrollment ID: I20090609000332  | 
| Provider Name | Uche O Akwuba | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1992972269 PECOS PAC ID: 5597817304 Enrollment ID: I20090708000659  | 
| Provider Name | Albert Chang | 
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology | 
| Provider Identifiers | NPI Number: 1083869226 PECOS PAC ID: 4486706561 Enrollment ID: I20090721000432  | 
| Provider Name | George A Zikos | 
|---|---|
| Provider Type | Practitioner - Optometry | 
| Provider Identifiers | NPI Number: 1740430941 PECOS PAC ID: 0446397152 Enrollment ID: I20091029000498  | 
| Provider Name | Sara Karimi | 
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology | 
| Provider Identifiers | NPI Number: 1356473540 PECOS PAC ID: 6709913205 Enrollment ID: I20100414000549  | 
| Provider Name | Michele L Tyler | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1861704314 PECOS PAC ID: 3072794601 Enrollment ID: I20110302000040  | 
| Provider Name | Luisette Cuebas | 
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) | 
| Provider Identifiers | NPI Number: 1184697963 PECOS PAC ID: 5395920300 Enrollment ID: I20110505000785  | 
| Provider Name | Sanjay Upadhyay | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1538350053 PECOS PAC ID: 2668657685 Enrollment ID: I20110506000005  | 
| Provider Name | N Gadie Taylor-kamara | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1710122262 PECOS PAC ID: 5294910212 Enrollment ID: I20110506000022  | 
| Provider Name | Schevaughn M Carr Celestine | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1992779508 PECOS PAC ID: 2062697097 Enrollment ID: I20110506000091  | 
| Provider Name | Marguerite G Bernard | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1952374613 PECOS PAC ID: 8123203163 Enrollment ID: I20110506000253  | 
| Provider Name | Suja Maria Sabastin | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1073703773 PECOS PAC ID: 3870785512 Enrollment ID: I20110624000218  | 
| Provider Name | Daniel S Behin | 
|---|---|
| Provider Type | Practitioner - Gastroenterology | 
| Provider Identifiers | NPI Number: 1386887438 PECOS PAC ID: 1557531290 Enrollment ID: I20110907000941  | 
| Provider Name | Diane Traver | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1962466300 PECOS PAC ID: 3870764251 Enrollment ID: I20110914000778  | 
| Provider Name | Charles Colclough | 
|---|---|
| Provider Type | Practitioner - Clinical Social Worker | 
| Provider Identifiers | NPI Number: 1740490796 PECOS PAC ID: 5496928947 Enrollment ID: I20111029000034  | 
| Provider Name | Sharon Pluskalowski | 
|---|---|
| Provider Type | Practitioner - Clinical Social Worker | 
| Provider Identifiers | NPI Number: 1669487336 PECOS PAC ID: 4789858945 Enrollment ID: I20111128000366  | 
| Provider Name | Armando Bernal | 
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology | 
| Provider Identifiers | NPI Number: 1447540281 PECOS PAC ID: 8820245061 Enrollment ID: I20120823000487  | 
| Provider Name | Karuna S Seidman | 
|---|---|
| Provider Type | Practitioner - Optometry | 
| Provider Identifiers | NPI Number: 1588928741 PECOS PAC ID: 1254589088 Enrollment ID: I20120919000493  | 
| Provider Name | Hernan C Del Arca | 
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology | 
| Provider Identifiers | NPI Number: 1073500518 PECOS PAC ID: 0345206553 Enrollment ID: I20130821000074  | 
| Provider Name | Amanda R Mondesir | 
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) | 
| Provider Identifiers | NPI Number: 1184976672 PECOS PAC ID: 1557504545 Enrollment ID: I20130823000122  | 
| Provider Name | Suresh K Nayudu | 
|---|---|
| Provider Type | Practitioner - Gastroenterology | 
| Provider Identifiers | NPI Number: 1447427711 PECOS PAC ID: 7810113214 Enrollment ID: I20140721001246  | 
| Provider Name | Aisha K Clay | 
|---|---|
| Provider Type | Practitioner - Pediatric Medicine | 
| Provider Identifiers | NPI Number: 1487749685 PECOS PAC ID: 5193944890 Enrollment ID: I20140911000429  | 
| Provider Name | Ebony Copeland | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1548404031 PECOS PAC ID: 7214158740 Enrollment ID: I20141024001523  | 
| Provider Name | Richa Garg | 
|---|---|
| Provider Type | Practitioner - Optometry | 
| Provider Identifiers | NPI Number: 1306273420 PECOS PAC ID: 8921321787 Enrollment ID: I20141231000161  | 
| Provider Name | Lois Jeannine Bookhardt Murray | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1609805472 PECOS PAC ID: 3375869068 Enrollment ID: I20150223001203  | 
| Provider Name | Desiree Outlaw | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1790051910 PECOS PAC ID: 1658697495 Enrollment ID: I20150313000499  | 
| Provider Name | Laurie J Brucia | 
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) | 
| Provider Identifiers | NPI Number: 1063661973 PECOS PAC ID: 2668540964 Enrollment ID: I20150317001410  | 
| Provider Name | Kim Forrester Dumont | 
|---|---|
| Provider Type | Practitioner - Pediatric Medicine | 
| Provider Identifiers | NPI Number: 1023336245 PECOS PAC ID: 0143549121 Enrollment ID: I20150427000247  | 
| Provider Name | Akosua A Childs | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1700292935 PECOS PAC ID: 4082929427 Enrollment ID: I20150814012998  | 
| Provider Name | Tresa S Prince | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1801295373 PECOS PAC ID: 2466760400 Enrollment ID: I20150924002316  | 
| Provider Name | Taina R Lopez | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1538562061 PECOS PAC ID: 5597074922 Enrollment ID: I20151026000355  | 
| Provider Name | A Jill Leibman | 
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology | 
| Provider Identifiers | NPI Number: 1144385006 PECOS PAC ID: 6002099215 Enrollment ID: I20151117002668  | 
| Provider Name | Yasmin Bahar | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1790161529 PECOS PAC ID: 2163722083 Enrollment ID: I20151130000007  | 
| Provider Name | Andrew Wan | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1982049888 PECOS PAC ID: 3375846546 Enrollment ID: I20160121001142  | 
| Provider Name | Dana Serafin | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1184082729 PECOS PAC ID: 6901105667 Enrollment ID: I20160502000208  | 
| Provider Name | Ameeka George | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1740664523 PECOS PAC ID: 3072812742 Enrollment ID: I20160502000517  | 
| Provider Name | Lara Elizabeth Trevino | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1487046397 PECOS PAC ID: 4688963465 Enrollment ID: I20160518000571  | 
| Provider Name | Rafaela M De La Huerta | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1720462708 PECOS PAC ID: 2163712126 Enrollment ID: I20160602001893  | 
| Provider Name | Dara Y. Herman | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1720449416 PECOS PAC ID: 9234422940 Enrollment ID: I20160718002134  | 
| Provider Name | Michael Jae Woo Kim | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1578955019 PECOS PAC ID: 7214218064 Enrollment ID: I20170110001546  | 
| Provider Name | Brian G Cole | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1184678955 PECOS PAC ID: 5496646655 Enrollment ID: I20170112001216  | 
| Provider Name | Anastasia Gretsas | 
|---|---|
| Provider Type | Practitioner - Clinical Social Worker | 
| Provider Identifiers | NPI Number: 1053500769 PECOS PAC ID: 1052694122 Enrollment ID: I20170215002236  | 
| Provider Name | Donna Ann-marie Saunders | 
|---|---|
| Provider Type | Practitioner - Clinical Social Worker | 
| Provider Identifiers | NPI Number: 1275629248 PECOS PAC ID: 5991930935 Enrollment ID: I20170503001727  | 
| Provider Name | Elsie A Bermudez Pouchard | 
|---|---|
| Provider Type | Practitioner - Psychiatry | 
| Provider Identifiers | NPI Number: 1780955021 PECOS PAC ID: 3476796574 Enrollment ID: I20170503001751  | 
| Provider Name | Carrie Elise Friedman | 
|---|---|
| Provider Type | Practitioner - Optometry | 
| Provider Identifiers | NPI Number: 1275985228 PECOS PAC ID: 6305117177 Enrollment ID: I20170814000321  | 
| Provider Name | Simone Dos Santos Ferreira Parker | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1144759432 PECOS PAC ID: 3375815368 Enrollment ID: I20170825002579  | 
| Provider Name | Stephanie Louise Traver | 
|---|---|
| Provider Type | Practitioner - Clinical Social Worker | 
| Provider Identifiers | NPI Number: 1679019384 PECOS PAC ID: 5890068175 Enrollment ID: I20170908000024  | 
| Provider Name | Sasidhar Gunturu | 
|---|---|
| Provider Type | Practitioner - Psychiatry | 
| Provider Identifiers | NPI Number: 1730443870 PECOS PAC ID: 2163792854 Enrollment ID: I20170921000816  | 
| Provider Name | Patrice Toni Grant | 
|---|---|
| Provider Type | Practitioner - Optometry | 
| Provider Identifiers | NPI Number: 1750738159 PECOS PAC ID: 8820362973 Enrollment ID: I20170928000197  | 
| Provider Name | Brenda Luisa Brathwaite | 
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) | 
| Provider Identifiers | NPI Number: 1427100577 PECOS PAC ID: 0345500260 Enrollment ID: I20180213003016  | 
| Provider Name | Salvattore L L Portocarrero | 
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice | 
| Provider Identifiers | NPI Number: 1164938155 PECOS PAC ID: 6507127123 Enrollment ID: I20180222002096  | 
| Provider Name | Gabrielle Lisnoff | 
|---|---|
| Provider Type | Practitioner - Clinical Social Worker | 
| Provider Identifiers | NPI Number: 1760920979 PECOS PAC ID: 9931463148 Enrollment ID: I20180515002252  | 
| Provider Name | Cavel S Miller | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1881922094 PECOS PAC ID: 7416208616 Enrollment ID: I20180927001698  | 
| Provider Name | Asya Portnaya | 
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) | 
| Provider Identifiers | NPI Number: 1144417429 PECOS PAC ID: 0143573063 Enrollment ID: I20181023002343  | 
| Provider Name | Kenisha Cassandra Smith | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1710463641 PECOS PAC ID: 0345589131 Enrollment ID: I20190221001543  | 
| Provider Name | Baraqat Adewole | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1689916389 PECOS PAC ID: 6406195007 Enrollment ID: I20190226001748  | 
| Provider Name | Malba Kwabena Nanyame | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1417426636 PECOS PAC ID: 9133469133 Enrollment ID: I20190328001026  | 
| Provider Name | Joy C. Chris-onuoha | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1801352521 PECOS PAC ID: 0345581252 Enrollment ID: I20190402002298  | 
| Provider Name | Edwin Cohen Azarkian | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1609290519 PECOS PAC ID: 1759683709 Enrollment ID: I20190521001119  | 
| Provider Name | Toshiba E Williams | 
|---|---|
| Provider Type | Practitioner - Clinical Social Worker | 
| Provider Identifiers | NPI Number: 1912332362 PECOS PAC ID: 6901132299 Enrollment ID: I20190724002085  | 
| Provider Name | Joy Ofili | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1205346913 PECOS PAC ID: 9638406853 Enrollment ID: I20190812001470  | 
| Provider Name | Christopher Michael Souza | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1568023612 PECOS PAC ID: 8729317227 Enrollment ID: I20190909002958  | 
| Provider Name | Marshall Tse | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1235369257 PECOS PAC ID: 6901135383 Enrollment ID: I20190910002748  | 
| Provider Name | Whitney Rebecca White | 
|---|---|
| Provider Type | Practitioner - Dentist | 
| Provider Identifiers | NPI Number: 1184125551 PECOS PAC ID: 2062742083 Enrollment ID: I20190918000302  | 
| Provider Name | Yvonne L Figarella | 
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology | 
| Provider Identifiers | NPI Number: 1225368939 PECOS PAC ID: 2961839733 Enrollment ID: I20200218000788  | 
| Provider Name | Annette Roldan | 
|---|---|
| Provider Type | Practitioner - Clinical Social Worker | 
| Provider Identifiers | NPI Number: 1629458500 PECOS PAC ID: 4183052574 Enrollment ID: I20200318001201  | 
| Provider Name | Kaleena Danetta Clarkson | 
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional | 
| Provider Identifiers | NPI Number: 1366993081 PECOS PAC ID: 3678903614 Enrollment ID: I20200415001879  | 
| Provider Name | Philip Boadu | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1992314439 PECOS PAC ID: 5294148391 Enrollment ID: I20210111000793  | 
| Provider Name | Tae Kyung Lee | 
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice | 
| Provider Identifiers | NPI Number: 1407511009 PECOS PAC ID: 6305222712 Enrollment ID: I20221007000425  | 
| Provider Name | Randi Delirod | 
|---|---|
| Provider Type | Practitioner - Clinical Social Worker | 
| Provider Identifiers | NPI Number: 1124535026 PECOS PAC ID: 0244609543 Enrollment ID: I20221208001233  | 
| Provider Name | Jorge Arturo Arzac | 
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology | 
| Provider Identifiers | NPI Number: 1306823661 PECOS PAC ID: 9133376171 Enrollment ID: I20250221000760  | 
| Provider Name | Rachel Amelia Cassetta | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1972107209 PECOS PAC ID: 0941710818 Enrollment ID: I20250610001619  | 
Mmc Medical Park At 1635 Poplar Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: Mmc Medical Park At 1635 Poplar, 1635 Poplar Street, Bronx, NY 10461 Phone: 914-377-4722  | |
Mmc At Aecom Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1300 Morris Park Avenue, Mmc At Aecom, Bronx, NY 10461 Phone: 914-377-4722  | |
Brightpoint Health Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1543-1545 Inwood Avenue, Bronx, NY 10452 Phone: 855-687-8700 Fax: 718-294-4765  | |
Aramark Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1650 Grand Concourse, Bronx, NY 10457 Phone: 646-641-7427  | |
Montefiore Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 260 E 161st St, Bronx, NY 10451 Phone: 718-920-4321  | |
Amth Medical Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 369 E 149th St, 4th Floor, Bronx, NY 10455 Phone: 718-665-8300  | |
New Genesis Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3485 E Tremont Ave Fl 2, Bronx, NY 10465 Phone: 718-828-1549 Fax: 516-303-0968  |