CONCOURSE MEDICAL CENTER INC
Ambulatory Health at Morris Ave, Bronx, NY

License number
New York 090111295
Category
Ambulatory Health
Type
Methadone
Owner
Name: MS. ANA MERCEDES MATOS CASAC
Title: ASSOCIATE EXECUTIVE DIRECTOR
Phone: (718) 665-9340
Address
Address
880 Morris Ave, Bronx, NY 10451
National Provider ID: 1073722286
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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CONCOURSE MEDICAL CENTER INC

880 Morris Ave, Bronx, NY 10451

Registration:
Feb 22, 2001
State ID:
2608839
Business type:
DOMESTIC BUSINESS CORPORATION
Emigdio Bucobo Md, 880 Morris Ave, Bronx, NY 10451 (Physical)
Agent:
Maxine Geller,880 Morris Ave, Bronx, NY 10451 (Physical)

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