Healthcare Provider Details

I. General information

NPI: 1114183241
Provider Name (Legal Business Name): BEE-HEALTHY PEDIATRICS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2008
Last Update Date: 07/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

94 5TH AVE
BROOKLYN NY
11217-3259
US

IV. Provider business mailing address

94 5TH AVE
BROOKLYN NY
11217-3259
US

V. Phone/Fax

Practice location:
  • Phone: 718-399-9600
  • Fax:
Mailing address:
  • Phone: 718-399-9600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number175992
License Number StateNY

VIII. Authorized Official

Name: DAVID PAUL CABBAD
Title or Position: PRESIDENT
Credential: M.D.
Phone: 718-399-9600