Healthcare Provider Details

I. General information

NPI: 1194657049
Provider Name (Legal Business Name): PEDIATRICS & OB/GYN OF NY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 LUDLOW ST STE 702
YONKERS NY
10705-1951
US

IV. Provider business mailing address

13 DENNIS LN
PLEASANTVILLE NY
10570-1029
US

V. Phone/Fax

Practice location:
  • Phone: 914-966-6100
  • Fax:
Mailing address:
  • Phone: 347-749-4439
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: EMMANUEL DIAZ GUERRERO
Title or Position: OWNER
Credential: MD
Phone: 347-749-4439