Healthcare Provider Details

I. General information

NPI: 1457574477
Provider Name (Legal Business Name): IKR PEDIATRIC ALLERGY & PULMONOLOGY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2007
Last Update Date: 07/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 EAST 66TH STREET
NEW YORK NY
10021
US

IV. Provider business mailing address

301 EAST 66TH STREET
NEW YORK NY
10021
US

V. Phone/Fax

Practice location:
  • Phone: 212-650-9000
  • Fax: 212-650-9189
Mailing address:
  • Phone: 212-650-9000
  • Fax: 212-650-9189

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. INGRID K ROSNER
Title or Position: MD OWNER
Credential: MD
Phone: 212-650-9000