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General NPI Number Information
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NPI Number | 1184817389
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Entity Type | Organization
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Legal Business Name | SCHENECTADY PEDIATRICS
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Dates
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Enumeration Date | 08/21/2007
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Last Update Date | 08/21/2007
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Provider Practice Location Address
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Address Line | 1726 CAMPBELL AVE
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City | SCHENECTADY
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State | NY
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Zip | 12306-5014
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Country | US
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Telephone | 518-372-5370
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Fax | 518-372-3472
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Provider Business Mailing Address
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Address Line | 1726 CAMPBELL AVENUE
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City | SCHENECTADY
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State | NY
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Zip | 12306
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Country | US
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Telephone | 518-372-5370
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Fax | 518-372-3472
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Authorized Official
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Title or Position | ADMIN ASST
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Name | MRS. WENDY J DAUNAIS
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Credential | ASST
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Telephone | 518-372-5370
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 1383591
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 1331021
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License Number State | NY
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