MEDICARE: COMMUNITY PEDIATRICS,PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	210150	NY

General Provider Information

NPI Number	:	1235390063
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY PEDIATRICS,PC

Provider Business Mailing Address
First Line	:	657 E 233RD ST
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10466-2801
Country	:	US
Telephone Number	:	718-882-6388
Fax Number	:	718-882-6396

Provider Business Practice Location Address
First Line	:	657 E 233RD ST
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10466-2801
Country	:	US
Telephone Number	:	718-882-6388
Fax Number	:	718-882-6396

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. AUGUSTINE T. AKALONU
Credential	:	M.D.
Telephone Number	:	718-882-6388

Provider Enumeration Date	:	06/24/2008
Last Update Date	:	06/24/2008

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