CCN GENERAL MEDICINE PLLC (NPI# 1902120025) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902120025 |
| Entity Type | Organization |
| Organization Name | CCN GENERAL MEDICINE PLLC |
| Practice Address |
1262 Boston Rd Suite 2 Bronx NY 10456-3602 |
| Practice Telephone | 7185697929 |
| Practice Fax Number | 3475905482 |
| Mailing Telephone | 7185697929 |
| Enumeration Date | 2010-03-18 |
| Last Update Date | 2010-07-08 |
| Authorized Official Name | DR. CECILIA G CALDERON (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 7185697929 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
255626 | NY | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 02932589 | 05 | |
| NY | NPI | 1427118140 | 01 |
| Street Address |
1262 BOSTON RD SUITE 2 |
| City | BRONX |
| State | NY |
| Zip Code | 10456-3602 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255408365 | Jorge Luis Cornielle | Pediatrics | 1262 Boston Rd, Bronx, NY 10456-3602 | 2006-11-30 |
| 1114551249 | Marsha Minaya | Nurse Practitioner | 1262 Boston Rd, Bronx, NY 10456-3602 | 2020-02-27 |
| 1376028647 | Heart of Ny Cardiology, PC | Internal Medicine | 1262 Boston Rd, Bronx, NY 10456-3602 | 2018-10-02 |
| 1699210633 | Debra Ann Mestre | Nurse Practitioner | 1262 Boston Rd, Bronx, NY 10456-3602 | 2016-12-29 |
| 1043682040 | Boston Pediatrics Pllc | Nurse Practitioner | 1262 Boston Rd, Bronx, NY 10456-3602 | 2015-10-29 |
| 1154725968 | Estefany Yanerys Morillo Tamayo | Pediatrics | 1262 Boston Rd, Suite 1, Bronx, NY 10456-3602 | 2014-10-22 |
| 1629358908 | Brmc Medical Pllc | Specialist | 1262 Boston Rd, 2nd Floor, Bronx, NY 10456-3602 | 2011-08-18 |
| 1689960395 | Lorena Grullon-figueroa Md, Pllc | Clinic/Center | 1262 Boston Rd, Bronx, NY 10462 | 2011-06-21 |
| 1437456209 | Medical Handling, Corp | Durable Medical Equipment & Medical Supplies | 1262 Boston Rd, Bronx, NY 10456-3602 | 2011-02-14 |
| 1275724767 | Boston Pediatrics, Pllc | Pediatrics | 1262 Boston Rd, Suite 1, Bronx, NY 10456-3602 | 2007-08-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336778281 | Danielle O'reggio Nurse Practicioner In Family Health P.C. | Nurse Practitioner | 1200 Webster Ave., Bronx, NY 10456 | 2020-04-03 |
| 1326678111 | New York Dialysis Services, Inc | Clinic/Center | 794 St Anns Ave, Bronx, NY 10456 | 2020-01-21 |
| 1174163430 | Emmanuel Guzman | Speech-Language Pathologist | 968 Cauldwell Avenue Rm 307, Bronx, NY 10456 | 2020-01-14 |
| 1154988194 | Arun George Prasad | Student in an Organized Health Care Education/Training Program | 1276 Fulton Avenue, Bronxcare Health System-fulton Divi, Psychiatry Residency, 5th Floor, Bronx, NY 10456 | 2019-05-24 |
| 1619431574 | Soroush Pakniyat-jahromi | Student in an Organized Health Care Education/Training Program | 1276 Fulton Ave. 5th Floor, Bronx, NY 10456 | 2019-01-24 |
| 1548745078 | Danielle Renee O'reggio | Nurse Practitioner | 1210 Webster Ave, Bronx, NY 10456 | 2018-10-01 |
| 1154830537 | Renee Lucette Mills | Counselor | 1011 Washington Avenue, 1st Floor, Bronx, NY 10456 | 2017-09-28 |
| 1487177572 | Webster Urgent Care, P.C. | Clinic/Center | 1210 Webster Avenue, Bronx, NY 10456 | 2017-07-20 |
| 1508395864 | Cheryl Roxann Camp | Counselor | 530 East 169th Street, Apt. 10e, Bronx, NY 10456 | 2017-06-08 |
| 1336683465 | Lorraine Dukes | Health Educator | 778 Forest Ave., P17x, Bronx, NY 10456 | 2016-12-08 |
| Find all providers in zip 10456 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033718085 | Palliative Care Consulting Services | Clinic/Center | 1188 Fox St, Bronx, NY 10459-1810 | 2020-10-21 |
| 1154988897 | Bissalam Medical LLC | Clinic/Center | 3391 3rd Ave Ste 1, Bronx, NY 10456-5355 | 2019-05-28 |
| 1275026635 | Kingsbridge Medical Services, Pllc | Clinic/Center | 5546 Broadway, Bronx, NY 10463-5250 | 2018-06-11 |
| 1083102008 | Maxwell Apenteng | Clinic/Center | 1248 E 224th St Apt 2, Bronx, NY 10466-5806 | 2018-04-25 |
| 1164941209 | Crisis Recovery Network, LLC | Clinic/Center | 2800 Bruckner Blvd Ste 302, Bronx, NY 10465-1972 | 2017-09-10 |
| 1710365622 | Stephanie Ann Salas Md Pllc | Clinic/Center | 1200 Waters Pl Ste 102, Bronx, NY 10461-2729 | 2015-05-12 |
| 1184011892 | Gracelife Family Health Np PC | Clinic/Center | 4027 Amundson Ave Fl 1, Bronx, NY 10466-2330 | 2015-04-20 |
| 1366834186 | Flora Antwi Np In Family Health PC | Clinic/Center | 3586 Boston Rd, Bronx, NY 10469-2519 | 2015-03-03 |
| 1942645247 | Bronx Community Medicine, Pllc | Clinic/Center | 2676 Grand Concourse # A, Bronx, NY 10458-4914 | 2013-05-01 |
| 1699032268 | Rs Medical Office P C | Clinic/Center | 2152 Starling Ave, Bronx, NY 10462-4303 | 2012-04-19 |
| 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.