MEDICARE: I C A PEDIATRICS

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	225007	NY

General Provider Information

NPI Number	:	1730523242
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	I C A PEDIATRICS

Provider Business Mailing Address
First Line	:	359 AVENUE U
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11223-3937
Country	:	US
Telephone Number	:	718-787-1017
Fax Number	:	718-787-1032

Provider Business Practice Location Address
First Line	:	359 AVENUE U
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11223-3937
Country	:	US
Telephone Number	:	718-787-1017
Fax Number	:	718-787-1032

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. SAMUEL BEKAR
Credential	:	M.D.
Telephone Number	:	718-787-1017

Provider Enumeration Date	:	04/26/2013
Last Update Date	:	04/26/2013

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Directions to “I C A PEDIATRICS ” Practice Location

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