Provider Demographics
NPI:1124632799
Name:NEIGHBORHOOD FAMILY MEDICAL SERVICES PC
Entity type:Organization
Organization Name:NEIGHBORHOOD FAMILY MEDICAL SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:914-204-3938
Mailing Address - Street 1:43 E 167TH ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10452-8206
Mailing Address - Country:US
Mailing Address - Phone:718-992-2128
Mailing Address - Fax:718-588-2045
Practice Address - Street 1:43 E 167TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10452-8206
Practice Address - Country:US
Practice Address - Phone:718-992-2128
Practice Address - Fax:718-588-2045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-01
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty