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General NPI Number Information
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NPI Number | 1992928071
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Entity Type | Organization
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Legal Business Name | ST MARY'S HOSPITAL FOR CHILDREN
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 2901 216TH ST
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City | BAYSIDE
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State | NY
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Zip | 11360-2810
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Country | US
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Telephone | 718-281-8800
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Fax |
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Provider Business Mailing Address
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Address Line | 2901 216TH ST
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City | BAYSIDE
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State | NY
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Zip | 11360-2810
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Country | US
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Telephone | 718-281-8800
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MS. FREDERIQUE ALTIDOR
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Credential |
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Telephone | 718-281-8688
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number | 700330N
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License Number State | NY
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