Healthcare Provider Details

I. General information

NPI: 1457673527
Provider Name (Legal Business Name): CHILDREN OF ZION PEDIATRICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2010
Last Update Date: 10/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 E 149TH ST SUITE A
BRONX NY
10451-5524
US

IV. Provider business mailing address

PO BOX 1225
SCARSDALE NY
10583-9225
US

V. Phone/Fax

Practice location:
  • Phone: 718-665-3387
  • Fax: 718-665-3388
Mailing address:
  • Phone: 718-665-3387
  • Fax: 718-665-3388

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number220927
License Number StateNY

VIII. Authorized Official

Name: DR. TAIYE OLUBUNMI APOESO
Title or Position: PRESIDENT
Credential: MD
Phone: 718-665-3387