Healthcare Provider Details

I. General information

NPI: 1255584843
Provider Name (Legal Business Name): SAW MILL PEDIATRICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2008
Last Update Date: 10/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

370 ELWOOD AVE
HAWTHORNE NY
10532-1258
US

IV. Provider business mailing address

370 ELWOOD AVE
HAWTHORNE NY
10532-1258
US

V. Phone/Fax

Practice location:
  • Phone: 914-449-6064
  • Fax: 914-449-6366
Mailing address:
  • Phone: 914-449-6064
  • Fax: 914-449-6366

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number205791
License Number StateNY

VIII. Authorized Official

Name: MRS. MARYANN HAMMEL
Title or Position: OFFICE MANGER
Credential:
Phone: 914-449-6064