Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Concourse Village Primary Care PLLC

Organization Specialist · NPI 1093984981

Concourse Village Primary Care PLLC provides Specialist services in Bronx, New York. Licensed in New York. Registered with an NPI since 2008.

Licensed in
NY
In the registry since
2008
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

769 Concourse Vlg W
Bronx, NY 10451-3801 Not confirmed with CMS for 18 years — call before visiting
Phone: (718) 402-4021
Fax: (718) 402-4023
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence 211364 (NY)

Record details

NPI number1093984981
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jean Macenat — President · (718) 402-4021
NPI enumeratedFebruary 25, 2008
Last updated in NPPESFebruary 25, 2008
Mailing address769 Concourse Vlg W, Bronx, NY 10451-3801

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