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General NPI Number Information
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NPI Number | 1912017781
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Entity Type | Organization
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Legal Business Name | FRIENDLY PEDIATRICS PC
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3099 CONEY ISLAND AVE
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City | BROOKLYN
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State | NY
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Zip | 11235
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Country | US
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Telephone | 718-891-3964
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Fax | 718-891-1101
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Provider Business Mailing Address
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Address Line | 3099 CONEY ISLAND AVE
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City | BROOKLYN
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State | NY
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Zip | 11235
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Country | US
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Telephone | 718-891-3964
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Fax | 718-891-1101
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Authorized Official
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Title or Position | PRESIDENT
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Name | BORIS RIPA
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Credential | MD
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Telephone | 718-891-3964
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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 | 207307
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License Number State | NY
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