Healthcare Provider Details

I. General information

NPI: 1568693737
Provider Name (Legal Business Name): KIDS CARE PEDIATRIC ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2009
Last Update Date: 08/05/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2266 DUTCH BROADWAY
ELMONT NY
11003-3507
US

IV. Provider business mailing address

2266 DUTCH BROADWAY
ELMONT NY
11003-3507
US

V. Phone/Fax

Practice location:
  • Phone: 516-775-0493
  • Fax: 516-775-0424
Mailing address:
  • Phone: 516-775-0493
  • Fax: 516-775-0424

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. STUART FEINSTEIN
Title or Position: PRESIDENT
Credential: MD
Phone: 516-775-0493