Healthcare Provider Details

I. General information

NPI: 1588635171
Provider Name (Legal Business Name): TRIBECA PEDIATRICS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2006
Last Update Date: 08/02/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46 WARREN ST
NEW YORK NY
10007-0025
US

IV. Provider business mailing address

46 WARREN ST
NEW YORK NY
10007-0025
US

V. Phone/Fax

Practice location:
  • Phone: 212-226-7666
  • Fax: 212-202-7988
Mailing address:
  • Phone: 212-226-7666
  • Fax: 212-202-7988

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number192772
License Number StateNY

VIII. Authorized Official

Name: MICHEL ARI COHEN
Title or Position: PHYSICIAN/OWNER
Credential: M.D.
Phone: 212-226-7666