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

1957 Bronx Medical PC

Organization Specialist · NPI 1396008801

1957 Bronx Medical PC is a Specialist in Rego Park, New York. Licensed in New York. Registered with an NPI since 2012.

Licensed in
NY
In the registry since
2012
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

9924 64th Ave
Rego Park, NY 11374-2645
Phone: (917) 842-2854
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence 221943 (NY)

Record details

NPI number1396008801
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Ilya Smuglin — Director · (917) 842-2854
NPI enumeratedJune 19, 2012
Last updated in NPPESJune 19, 2012
Mailing address9924 64th Ave, Rego Park, NY 11374-2645

Other providers in Rego Park