Healthcare Provider Details

I. General information

NPI: 1740825405
Provider Name (Legal Business Name): BOBDE PEDIATRICS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2019
Last Update Date: 11/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

970 N BROADWAY STE 303
YONKERS NY
10701-1311
US

IV. Provider business mailing address

970 N BROADWAY STE 303
YONKERS NY
10701-1311
US

V. Phone/Fax

Practice location:
  • Phone: 914-966-1900
  • Fax:
Mailing address:
  • Phone: 914-966-1900
  • Fax: 914-966-0028

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ELIZABETH PATSY BOBDE
Title or Position: PRESIDENT
Credential: MD
Phone: 914-527-3154