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General NPI Number Information
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NPI Number | 1720493513
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Entity Type | Organization
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Legal Business Name | FAMILY PEDIATRICS CARE
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Dates
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Enumeration Date | 07/01/2014
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Last Update Date | 07/01/2014
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Provider Practice Location Address
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Address Line | 13333 FRANCIS LEWIS BLVD
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City | LAURELTON
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State | NY
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Zip | 11413-2117
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Country | US
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Telephone | 516-503-7855
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Fax |
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Provider Business Mailing Address
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Address Line | 13333 FRANCIS LEWIS BLVD
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City | LAURELTON
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State | NY
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Zip | 11413-2117
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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 | LPN
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Name | NADGEFFRENA MARCENA
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Credential |
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Telephone | 516-503-7855
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 3180061
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License Number State | NY
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