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NPI 1396008801

OrganizationActive

1957 Bronx Medical P.C.

NPI 1396008801 · Specialist · Rego Park, NY

Provider details

NPI number: 1396008801
Entity type: Organization
Primary specialty: SpecialistOther Service Providers
Authorized official: Ilya Smuglin, Director
License: 221943 (NY)

Practice location

9924 64th Ave

Rego Park, NY 11374-2645

Phone: (917) 842-2854

More NY providers

Mailing address

9924 64th Ave

Rego Park, NY 11374-2645

Registry dates

Enumerated: 2012-06-19
Last updated: 2012-06-19

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.

1957 Bronx Medical P.C. — NPI 1396008801, Rego Park, NY | NPI Central