Healthcare Provider Details

I. General information

NPI: 1528133865
Provider Name (Legal Business Name): PEDIATRIC ASSOCIATES OF NORTH RIVERDALE, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3765 RIVERDALE AVE SUITE #4
BRONX NY
10463-1845
US

IV. Provider business mailing address

3765 RIVERDALE AVE SUITE #4
BRONX NY
10463-1845
US

V. Phone/Fax

Practice location:
  • Phone: 718-548-7300
  • Fax: 718-548-4123
Mailing address:
  • Phone: 718-548-7300
  • Fax: 718-548-4123

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number131573
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number163789
License Number StateNY

VIII. Authorized Official

Name: DR. ALAN M HIRSCHMAN
Title or Position: PHYSICIAN
Credential: MD
Phone: 718-548-7300