CONCOURSE MEDICAL CENTER INC (NPI# 1073722286) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073722286 |
| Entity Type | Organization |
| Organization Name | CONCOURSE MEDICAL CENTER INC |
| Practice Address |
880 Morris Ave Bronx NY 10451-3412 |
| Practice Telephone | 7186659340 |
| Mailing Telephone | 7186659340 |
| Mailing Fax Number | 7186652394 |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2019-03-12 |
| Authorized Official Name | MS. ANA MATOS (ACTING EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 7186659340 |
| Authorized Official Credential | CASAC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2800X |
Clinic/Center Specialization: Methadone Clinic |
090111295 | NY | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 02243034 | 05 | |
| NY | MEDICARE | A400073294 | 01 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | CONCOURSE MEDICAL CENTER INC. | 880 Morris Avenue, Bronx, Ny 10451 |
| Street Address |
880 MORRIS AVE |
| City | BRONX |
| State | NY |
| Zip Code | 10451-3412 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598139081 | Jeanette Perez | Counselor | 880 Morris Ave, Bronx, NY 10451-3412 | 2015-11-20 |
| 1396119897 | Yanira Delia Morales | Counselor | 880 Morris Ave, Bronx, NY 10451-3412 | 2015-11-20 |
| 1851765358 | Carol Blackwell | Counselor | 880 Morris Ave, Bronx, NY 10451-3412 | 2015-11-20 |
| 1306210950 | Janet Bucca | Licensed Practical Nurse | 880 Morris Ave, Bronx, NY 10451-3412 | 2015-11-19 |
| 1790159390 | Keshia Daniel Laporte | Registered Nurse | 880 Morris Ave, Bronx, NY 10451-3412 | 2015-11-19 |
| 1982078598 | Cecil Bankhead | Counselor | 880 Morris Ave, Bronx, NY 10451-3412 | 2015-11-19 |
| 1073987673 | Efrain Torres | Counselor | 880 Morris Ave, Bronx, NY 10451-3412 | 2015-11-19 |
| 1285008821 | Laurence Geller | Behavioral Analyst | 880 Morris Ave, Bronx, NY 10451-3412 | 2015-11-19 |
| 1346614955 | Maritza Monserrat | Licensed Practical Nurse | 880 Morris Ave, Bronx, NY 10451-3412 | 2015-11-19 |
| 1013381623 | Ana Mercedes Matos | Counselor | 880 Morris Ave, Bronx, NY 10451-3412 | 2015-11-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184221426 | Milena Boursiquot | Counselor | 240 Walton Ste 2n, Bronx, NY 10451 | 2020-10-08 |
| 1467065466 | Armghan Azhar Azhar Munir | Student in an Organized Health Care Education/Training Program | Lincoln Medical Center, 234 E149th St, New York City, NY 10451 | 2020-08-28 |
| 1013529486 | Ariane Tapang Yangco | Student in an Organized Health Care Education/Training Program | 234 East 149th St., Lincoln Medical and Mental Center, Internal Medicine De, New York, NY 10451 | 2020-08-18 |
| 1134730377 | Sherida N Edding | Student in an Organized Health Care Education/Training Program | 234 E 149th Street, Bronx, New York City, NY 10451 | 2020-08-12 |
| 1922617646 | Tian Fang Yu | Student in an Organized Health Care Education/Training Program | 234 E 149th St., The Bronx, NY 10451 | 2020-07-28 |
| 1659998037 | Amnah Khalid | Student in an Organized Health Care Education/Training Program | 234 East 149st, 820, Bronx, NY 10451 | 2020-07-01 |
| 1871116277 | Sebastian Andres Gandarillas Fraga | Student in an Organized Health Care Education/Training Program | 234 E. 149 Street, Suite 820, New York, NY 10451 | 2020-05-20 |
| 1285257642 | Javier Alejandro Castro Valenzuela | Student in an Organized Health Care Education/Training Program | 243 East 149th Street, Suite 4-20, The Bronx, NY 10451 | 2020-05-20 |
| 1992331482 | Montefiore Medical Center | Clinic/Center | 250 Thurman Munson Way #236, Bronx, NY 10451 | 2020-03-17 |
| 1235761958 | Kellie Gevon Mcfarlane | Psychologist | Lincoln Hospital, Child Adolescent Psychiatric Services, 234 East 149th Street, Floor 4a, Room 4-83, Bronx, NY 10451 | 2020-02-11 |
| Find all providers in zip 10451 | ||||
| Taxonomy Code | 261QM2800X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Methadone Clinic |
| An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction. |
| Notes: [7/1/2003: new] |
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| 1316301294 | Montefiore Medical Center | Clinic/Center | 2058 Jerome Ave, Bronx, NY 10453-1817 | 2016-04-07 |
| 1891154886 | Montefiore Medical Center | Clinic/Center | 1510 Waters Pl, Bronx, NY 10461-2700 | 2016-02-18 |
| 1235501313 | Samaritan Daytop Village, Inc. | Clinic/Center | 477 Willis Ave, Bronx, NY 10455-4015 | 2015-10-28 |
| 1114305406 | Narco Freedom Inc. | Clinic/Center | 477 Willis Ave, Bronx, NY 10455-4015 | 2015-05-07 |
| 1285947754 | Albert Einstein College of Medicine of Yeshiva University | Clinic/Center | 804 E 138th St, Bronx, NY 10454-1902 | 2010-07-26 |
| 1891837910 | Yeshiva University | Clinic/Center | 1500 Waters Place, Bpc Betty Parker Bldg Wd 20 6th Fl, Bronx, NY 10461 | 2007-02-13 |
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| 1770951204 | Beth Israel Medical Center | Clinic/Center | 160 Water St Fl 24, New York, NY 10038-4922 | 2015-09-15 |
| 1770885451 | The Guidance Center Cdtc | Clinic/Center | 20 Sickles Ave, New Rochelle, NY 10801-4030 | 2010-12-01 |
| 1265665954 | Northpointe Council Inc | Clinic/Center | 1001 11th Street, Niagra Falls, NY 14301 | 2009-08-27 |
| 1427125632 | Ses Operating Corp | Clinic/Center | 2367 -69 Second Ave, New York, NY 10035-3108 | 2006-11-30 |
| 1396843967 | Gramaercy Park Medical Group | Clinic/Center | 253 3rd Ave # 55, New York, NY 10010-7401 | 2006-09-20 |
| 1891897781 | County of Suffolk | Clinic/Center | 689 Jericho Tpke, Huntington Station, NY 11746-7501 | 2006-09-02 |
| 1669574547 | County of Suffolk | Clinic/Center | 200 Wireless Blvd, Hauppauge, NY 11788-3974 | 2006-09-02 |
| 1083618672 | Buffalo Beacon Corporation | Clinic/Center | 3354 Sheridan Dr, Amherst, NY 14226-1439 | 2005-06-10 |
| 1437798824 | Sisters of Charity Hospital of Buffalo New York | Clinic/Center | 158 Holden St, Buffalo, NY 14214-2226 | 2020-01-02 |
| 1679050116 | Nancy Arroyo | Clinic/Center | 311 W 35th St, New York, NY 10001-1701 | 2018-07-27 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.