Provider Demographics
NPI:1609030956
Name:BRONX COMPREHENSIVE HEMATOLOGY-ONCOLOGY, PLLC
Entity type:Organization
Organization Name:BRONX COMPREHENSIVE HEMATOLOGY-ONCOLOGY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ILMANA
Authorized Official - Middle Name:
Authorized Official - Last Name:FULGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-423-2029
Mailing Address - Street 1:243 PARK HILL AVE
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10705-1436
Mailing Address - Country:US
Mailing Address - Phone:914-423-2029
Mailing Address - Fax:914-423-2029
Practice Address - Street 1:4487 3RD AVE
Practice Address - Street 2:FOURTH FLOOR
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-1526
Practice Address - Country:US
Practice Address - Phone:718-960-6377
Practice Address - Fax:718-960-5522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-16
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY243615261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty