MEDICARE: PEDIATRIC STATION 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	261QP2300X	Primary Care Clinic/Center	F380500	NY

General Provider Information

NPI Number	:	1275704108
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEDIATRIC STATION PC

Provider Business Mailing Address
First Line	:	PO BOX 518
Second Line	:
City	:	BRONXVILLE
State	:	NY
Zip	:	10708-0518
Country	:	US
Telephone Number	:	718-329-2275
Fax Number	:	718-329-2276

Provider Business Practice Location Address
First Line	:	3050 GRAND CONCOURSE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10458-1306
Country	:	US
Telephone Number	:	718-329-2275
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ANASTASSIOS KYRIAKAKOS
Credential	:	MD
Telephone Number	:	718-329-2275

Provider Enumeration Date	:	03/19/2008
Last Update Date	:	03/29/2016

Similar Medicare Providers

1790148799 — BETSY NEGRON CPNP
Practice Location Address:

3050 GRAND CONCOURSE
BRONX, NY
10458-1306

Practice Phone: 718-329-2275
Practice Fax: 718-329-2276

1669677605 — ALAN J. ROSENTHAL DENTIST
Practice Location Address:

3530 HENRY HUDSON PKWY
BRONX, NY
10463-1306

Practice Phone: 171-854-3303
Practice Fax: 171-854-3284

1578748208 — MRS. HORTENSE STEPHENSON
Practice Location Address:

434 E 143RD ST
BRONX, NY
10454-1306

Practice Phone: 718-665-2175
Practice Fax:

1831423110 — JULIA CARR-ELLIS LMSW
Practice Location Address:

3530 HENRY HUDSON PKWY
BRONX, NY
10463-1306

Practice Phone: 917-322-9827
Practice Fax:

1043565625 — MR. RAYMUNDO D FERMIN LMSW, CASAC
Practice Location Address:

1306 COLLEGE AVE APT 1D
BRONX, NY
10456-1541

Practice Phone: 646-457-1468
Practice Fax:

1770834541 — DR. ALYSON MARGARET WAGNER DPT
Practice Location Address:

3530 HENRY HUDSON PKWY , APT PHB
BRONX, NY
10463-1306

Practice Phone: 917-612-1264
Practice Fax:

Directions to “PEDIATRIC STATION PC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.