Healthcare Provider Details

I. General information

NPI: 1295993947
Provider Name (Legal Business Name): NEOPEDS MEDICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2008
Last Update Date: 02/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 GRAND CONCOURSE FRNT 5
BRONX NY
10451-3003
US

IV. Provider business mailing address

800 GRAND CONCOURSE FRNT 5
BRONX NY
10451-3003
US

V. Phone/Fax

Practice location:
  • Phone: 718-401-8943
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number
License Number State

VIII. Authorized Official

Name: YVES G. VERNA
Title or Position: PRESIDENT
Credential: MD
Phone: 718-401-8943