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 is a Specialist 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
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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