Healthcare Provider Details

I. General information

NPI: 1609090018
Provider Name (Legal Business Name): ARTHUR AVENUE PEDIATRICS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2007
Last Update Date: 01/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2385 ARTHUR AVE SUITE #206
BRONX NY
10458-8184
US

IV. Provider business mailing address

2385 ARTHUR AVE SUITE #206
BRONX NY
10458-8184
US

V. Phone/Fax

Practice location:
  • Phone: 718-220-9755
  • Fax: 718-220-9757
Mailing address:
  • Phone: 718-220-9755
  • Fax: 718-220-9757

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: KAREN JOSETTE GREER
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 718-220-9755