Provider Demographics
NPI:1487077475
Name:VILLAGE DIAGNOSTIC & TREATMENT CENTER
Entity type:Organization
Organization Name:VILLAGE DIAGNOSTIC & TREATMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PATIENT SERVICE SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:BRITO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-337-9293
Mailing Address - Street 1:109 PARK HILL AVE # 3
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-4822
Mailing Address - Country:US
Mailing Address - Phone:347-280-4817
Mailing Address - Fax:
Practice Address - Street 1:109 PARK HILL AVE # 3
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-4822
Practice Address - Country:US
Practice Address - Phone:347-280-4817
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-27
Last Update Date:2014-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty