Healthcare Provider Details

I. General information

NPI: 1265535546
Provider Name (Legal Business Name): MAIMONIDES CHILDREN S CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 BAY RIDGE PARKWAY
BROOKLYN NY
11209
US

IV. Provider business mailing address

8214 18TH AVE.
BROOKLYN NY
11209
US

V. Phone/Fax

Practice location:
  • Phone: 718-745-4006
  • Fax:
Mailing address:
  • Phone: 718-331-3939
  • Fax: 718-331-4321

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC2000X
TaxonomyChildren's Hospital
License Number155908
License Number StateNY

VIII. Authorized Official

Name: DR. GARY R PEARLMAN
Title or Position: PEDS
Credential: MD
Phone: 718-331-3939