MEDICARE: WELCOME PEDIATRICS PLLC

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	208000000X	Pediatrics Physician	210663	NY
2	208000000X	Pediatrics Physician	210760	NY

General Provider Information

NPI Number	:	1528396025
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WELCOME PEDIATRICS PLLC

Provider Business Mailing Address
First Line	:	8631 14TH AVENUE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11228-3413
Country	:	US
Telephone Number	:	718-496-5126
Fax Number	:	866-903-8106

Provider Business Practice Location Address
First Line	:	2287 NOSTRAND AVENUE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11210-3839
Country	:	US
Telephone Number	:	718-258-9888
Fax Number	:	347-462-4257

Authorized Official
Title or Position	:	OWNER
Name	:	DR. SVETLANA SPIVAK
Credential	:	MD
Telephone Number	:	718-258-9888

Provider Enumeration Date	:	11/23/2009
Last Update Date	:	10/20/2020

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