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General NPI Number Information
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NPI Number | 1306920251
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Entity Type | Organization
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Legal Business Name | PEDIATRICS EAST OF NY PC
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 157 EAST 81ST ST
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City | NEW YORK
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State | NY
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Zip | 10028-1844
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Country | US
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Telephone | 212-879-7014
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Fax | 212-628-8147
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Provider Business Mailing Address
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Address Line | 157 EAST 81ST ST
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City | NEW YORK
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State | NY
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Zip | 10028-1844
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Country | US
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Telephone | 212-879-7014
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Fax | 212-628-8147
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Authorized Official
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Title or Position | SECRETARY PARTNER
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Name | DR. JULIA KIM YANG
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Credential | MD
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Telephone | 212-879-7014
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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