| NPI | 1396090932 |
|---|---|
| NPI Type | NPI-2 Organization |
| Status | Active |
| Enumeration Date | 2012-07-19 |
| Last Updated | 2019-10-17 |
| Authorized Official | Svetlana Khandros PRESIDENT Phone: 7182200439 |
| Mailing Address | 2336 Grand Concourse Bronx, NY 10458-6903 United States Phone: (718) 220-0439 | Fax: (718) 933-2914 📍 View Map |
| Primary Practice Address | 2336 Grand Concourse Bronx, NY 10458-6903 United States Phone: (718) 907-0195 📍 View Map |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| Yes | 207Q00000X – Family Medicine | NY | 228243 |
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About NPI 1396090932
Southern Wellcare Medical Pc is an organization registered in the CMS NPPES NPI Registry with NPI number 1396090932. The primary specialty listed is Family Medicine. The organization is located in Bronx, NY. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2012-07-19. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1396090932?
NPI 1396090932 belongs to Southern Wellcare Medical Pc, a Family Medicine in Bronx, NY. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.
Is NPI 1396090932 active?
The current status of NPI 1396090932 in the NPPES registry is Active. The record was last updated on 2019-10-17.
What specialty is NPI 1396090932?
NPI 1396090932 is classified under the taxonomy Family Medicine. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1396090932?
You can verify NPI 1396090932 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1396090932?
The primary practice address on file for NPI 1396090932 is 2336 Grand Concourse, Bronx, NY 10458-6903. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1396090932 issued?
NPI 1396090932 was first issued (enumerated) on 2012-07-19. The NPPES record was last updated on 2019-10-17.
Practice Location Map
Southern Wellcare Medical Pc is located at 2336 Grand Concourse, Bronx, NY. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Southern Wellcare Medical Pc. All records sourced from the CMS NPPES registry.
License Information
The following state license numbers are on file in the NPPES registry for NPI 1396090932. For license status verification, contact the relevant state licensing board directly.
| Specialty / Taxonomy | License Number | State |
|---|---|---|
| Family Medicine | 228243 | NY |