Healthcare Provider Details

I. General information

NPI: 1578534103
Provider Name (Legal Business Name): CARNEGIE HILL PEDIATRICS, LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1125 PARK AVE
NEW YORK NY
10128-1243
US

IV. Provider business mailing address

1125 PARK AVE
NEW YORK NY
10128-1243
US

V. Phone/Fax

Practice location:
  • Phone: 212-289-1400
  • Fax: 212-289-5714
Mailing address:
  • Phone: 212-289-1400
  • Fax: 212-289-5714

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number5505617
License Number StateNY

VIII. Authorized Official

Name: DR. BARRY BIALER STEIN
Title or Position: PARTNER
Credential: M.D.
Phone: 212-289-1400