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General NPI Number Information
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NPI Number | 1518270214
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Entity Type | Organization
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Legal Business Name | DR. T'S PEDIATRICS PLLC
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Dates
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Enumeration Date | 07/22/2010
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Last Update Date | 10/02/2020
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Provider Practice Location Address
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Address Line | 11206 71ST RD
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City | FOREST HILLS
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State | NY
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Zip | 11375-4643
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Country | US
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Telephone | 718-520-8585
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Fax |
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Provider Business Mailing Address
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Address Line | 11206 71ST RD
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City | FOREST HILLS
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State | NY
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Zip | 11375-4643
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | ARKADIY TAKHALOV
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Credential | MD
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Telephone | 718-520-8585
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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 |
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License Number State |
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