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General NPI Number Information
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NPI Number | 1316304231
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Entity Type | Organization
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Legal Business Name | PEDIATRIC CARE OF NEW YORK P.C.
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Dates
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Enumeration Date | 01/22/2016
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Last Update Date | 01/22/2016
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Provider Practice Location Address
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Address Line | 70 IRONMINE DR
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City | STATEN ISLAND
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State | NY
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Zip | 10304-1130
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Country | US
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Telephone | 347-432-9355
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Fax | 718-833-7465
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Provider Business Mailing Address
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Address Line | 1932 RICHMOND AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10314-3914
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Country | US
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Telephone | 347-432-9355
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. FAIZ O ALZOOBAEE
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Credential | M.D.
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Telephone | 347-432-9355
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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 | 223071-1
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License Number State | NY
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