=====================================================
General NPI Number Information
=====================================================
NPI Number | 1609169812
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ABC PEDIATRICS & MEDICAL PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/20/2011
-----------------------------------------------------
Last Update Date | 12/30/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 825 OCEAN PKWY STE 2
-----------------------------------------------------
City | BROOKLYN
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11230-2703
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-434-0300
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 227 CORBIN PL
-----------------------------------------------------
City | BROOKLYN
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11235-4901
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 347-742-0260
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | NATELA LEVI
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 718-769-3667
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208000000X
-----------------------------------------------------
Taxonomy Name | Pediatrics Physician
-----------------------------------------------------
License Number | 230201
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------