Healthcare Provider Details

I. General information

NPI: 1609169812
Provider Name (Legal Business Name): ABC PEDIATRICS & MEDICAL PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2011
Last Update Date: 12/30/2025
Certification Date: 12/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 OCEAN PKWY STE 2
BROOKLYN NY
11230-2703
US

IV. Provider business mailing address

227 CORBIN PL
BROOKLYN NY
11235-4901
US

V. Phone/Fax

Practice location:
  • Phone: 718-434-0300
  • Fax:
Mailing address:
  • Phone: 347-742-0260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number230201
License Number StateNY

VIII. Authorized Official

Name: NATELA LEVI
Title or Position: PRESIDENT
Credential: MD
Phone: 718-769-3667