| Organization Name: | MCC-NY |
| NPI Number: | 1275808669 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ANTHONY BUSSANICH (MD) |
| Mailing Address: | 150 Park Row Nyc |
| State: | NY US |
| Postal Code: | 10007 |
| Phone Number: | 6468366428 |
| Fax Number: | |
| NPI Enumeration Date: | 03/19/2012 |
| NPI Last Update Date: | 03/19/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Prison Health |
| Taxonomy Definition: | |