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General NPI Number Information
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NPI Number | 1508959529
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Entity Type | Organization
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Legal Business Name | DORCHESTER PEDIATRIC ASSOCIATES
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 11/04/2008
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Provider Practice Location Address
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Address Line | 871 OCEAN AVENUE
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City | BROOKLYN
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State | NY
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Zip | 11226
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Country | US
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Telephone | 718-282-2900
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Fax | 718-287-4378
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Provider Business Mailing Address
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Address Line | 871 OCEAN AVENUE
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City | BROOKLYN
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State | NY
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Zip | 11226
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Country | US
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Telephone | 718-282-2900
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Fax | 718-287-4378
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Authorized Official
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Title or Position | PARTNER
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Name | DR. T. STANLEY RICHARDS
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Credential | M.D.
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Telephone | 718-282-2900
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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 | 100043
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License Number State | NY
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