WATERS PLACE MEDICAL GROUP PC (NPI# 1497186456) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497186456 |
| Entity Type | Organization |
| Organization Name | WATERS PLACE MEDICAL GROUP PC |
| Practice Address |
1733 Eastchester Rd Bronx NY 10461-2315 |
| Mailing Address |
332 Covert Ave New Hyde Park NY 11040-5437 |
| Practice Telephone | 7189187901 |
| Practice Fax Number | 7189188364 |
| Mailing Telephone | 9176971550 |
| Mailing Fax Number | 7189188364 |
| Enumeration Date | 2013-12-02 |
| Last Update Date | 2017-03-13 |
| Authorized Official Name | BUN JIM (M.D.) |
| Authorized Official Telephone | 7189187901 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
Allopathic & Osteopathic Physicians |
| Street Address |
1733 EASTCHESTER RD |
| City | BRONX |
| State | NY |
| Zip Code | 10461-2315 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689014987 | Advanced Access Medical Care, Pllc | Radiology | 1733 Eastchester Rd, Bronx, NY 10461-2315 | 2013-07-01 |
| 1700227287 | Knickerbocker Dialysis Inc | Clinic/Center | 1733 Eastchester Rd, Bronx, NY 10461-2315 | 2013-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427665975 | Zhanna Kleynerman | Pharmacist | R&a Drugs Inc, 2562 Est Tremont Ave, Bronx, NY 10461 | 2020-09-29 |
| 1245867738 | Dalia Duzdar | Student in an Organized Health Care Education/Training Program | 1400 Pelham Pkwy S Building 6, Suite B125, Bronx, NY 10461 | 2020-03-24 |
| 1306486667 | Alvin Antony Mathew | Physical Therapist | 1500 Blondell Ave., Bronx, NY 10461 | 2020-01-14 |
| 1295374007 | Felicia Bowman | Peer Specialist | 55 Westchester Square Bronx, 55 Westchester Square Bronx, Bronx, NY 10461 | 2019-12-26 |
| 1477191161 | Todd Benevento Jr. | Physical Therapist | 1250 Waters Place Tower One 10th Floor, Bronx, NY 10461 | 2019-12-13 |
| 1073173845 | Harriet Sarpong-blankson | Pharmacist | Jack D Weiler Hospital, 1825 Eastchester Road, Bronx, NY 10461 | 2019-06-14 |
| 1396300166 | Victoria Sliva | Psychologist | 1400 Pelham Pkwy S Bldg 19w, Bldg 1, 9w, Bronx, NY 10461 | 2019-05-07 |
| 1538723366 | Shuai Wang | Student in an Organized Health Care Education/Training Program | 1400 Pelham Parkway South Jacobi Medical Center, Bronx, NY 10461 | 2019-04-26 |
| 1457810079 | Morpheus Sleep Solutions Inc | Durable Medical Equipment & Medical Supplies | 3004 Middletown Road, Lower Level Unit 1, Bronx, NY 10461 | 2019-03-13 |
| 1922565118 | Metro Care Management LLC | Case Management | 2481 Rowe St, Bronx, NY 10461 | 2019-02-25 |
| Find all providers in zip 10461 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417346321 | Maryanne Yacoub Sourial | Internal Medicine | 3411 Wayne Ave Apt 5h, Bronx, NY 10467-2539 | 2015-01-15 |
| 1437563137 | Bessy Suyin Flores Chang | Internal Medicine | 4422 3rd Ave Bldg 3, Bronx, NY 10457-2545 | 2014-06-20 |
| 1417225319 | Pablo Loarte Campos | Internal Medicine | 111 E 210th St Fl C2, Bronx, NY 10467-2401 | 2011-12-06 |
| 1437312758 | Bashar Ericsoossi | Internal Medicine | 1733 Eastchester Rd Ste 2, Bronx, NY 10461-2315 | 2008-07-07 |
| 1558532242 | Medical Diagnostic Nephrology, PC | Internal Medicine | 2409 Barker Ave, Bronx, NY 10467-7601 | 2008-03-20 |
| 1750460960 | Joseph Bonanno | Internal Medicine | 3481 E Tremont Ave, Bronx, NY 10465-2016 | 2006-11-06 |
| 1144310855 | Robert E Feingold | Internal Medicine | Mmc - Dept. of Nephrology, 111 East 210th Street, Bronx, NY 10467 | 2006-10-13 |
| 1659304756 | Ritesh Raichoudhury | Internal Medicine | 1874 Pelham Pkwy S Apt Lr, Bronx, NY 10461-3749 | 2006-07-09 |
| 1629000948 | Mario A Henriquez | Internal Medicine | 2452 Bronx Park E, Bronx, NY 10467-7503 | 2006-07-07 |
| 1295711950 | Robert Chiles Alvis | Internal Medicine | 3468 Park Avenue, Bronx, NY 10456 | 2005-12-15 |
| Find all providers in BRONX | ||||
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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.