Provider Demographics
NPI:1871994228
Name:ELMER ARTEAGA MEDICAL PC
Entity type:Organization
Organization Name:ELMER ARTEAGA MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ELMER
Authorized Official - Middle Name:C
Authorized Official - Last Name:ARTEAGA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:7182-204-4442
Mailing Address - Street 1:3201 GRAND CONCOURSE APT 2M
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10468-1226
Mailing Address - Country:US
Mailing Address - Phone:718-220-4442
Mailing Address - Fax:718-220-4546
Practice Address - Street 1:3201 GRAND CONCOURSE APT 2M
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10468-1226
Practice Address - Country:US
Practice Address - Phone:718-220-4442
Practice Address - Fax:718-220-4546
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-04
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY192323208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty