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General NPI Number Information
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NPI Number | 1750973368
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Entity Type | Organization
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Legal Business Name | PREMIER PEDIATRICS OF NEW YORK, PC
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Dates
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Enumeration Date | 02/04/2021
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Last Update Date | 02/04/2021
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Provider Practice Location Address
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Address Line | 2955 VETERANS RD W STE 2C
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City | STATEN ISLAND
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State | NY
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Zip | 10309-2504
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Country | US
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Telephone | 718-356-6000
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Fax | 718-356-6267
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Provider Business Mailing Address
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Address Line | 7 MORTON ST
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City | STATEN ISLAND
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State | NY
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Zip | 10306-1460
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Country | US
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Telephone | 917-922-2455
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Fax |
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Authorized Official
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Title or Position | CEO, PRESIDENT
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Name | DR. LINDA TERESA DI TORO
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Credential | MD
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Telephone | 718-356-6000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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