Healthcare Provider Details

I. General information

NPI: 1184783938
Provider Name (Legal Business Name): NORTH ROCKLAND PEDIATRIC ASSOCIOATES,P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/07/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

171 RAMAPO RD
GARNERVILLE NY
10923-1552
US

IV. Provider business mailing address

171 RAMAPO RD
GARNERVILLE NY
10923-1552
US

V. Phone/Fax

Practice location:
  • Phone: 845-947-1772
  • Fax: 845-947-4487
Mailing address:
  • Phone: 845-947-1772
  • Fax: 845-947-4487

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. ALLEN STEVEN LAUB
Title or Position: PRESIDENT
Credential: M.D.
Phone: 845-947-1772