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NPI Code Detail

MEDICARE: PEDIATRICS ASSOCIATES AT LICH

MEDICARE: PEDIATRICS ASSOCIATES AT LICH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1346297389
Entity Type Code : Organization
Provider Name (Legal Business Name) : PEDIATRICS ASSOCIATES AT LICH
Provider Business Mailing Address
First Line : 160 WATER ST
Second Line : 20FL
City : NEW YORK
State : NY
Zip : 10038-4922
Country : US
Telephone Number : 212-256-3682
Fax Number : 212-256-3538
Provider Business Practice Location Address
First Line : 97 AMITY ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11201-6004
Country : US
Telephone Number : 718-780-1821
Fax Number : 718-780-2898
Authorized Official
Title or Position : MANAGING EMPLOYEE
Name : STEPHEN TURNER
Credential : MD
Telephone Number : 718-780-1821
Provider Enumeration Date : 05/27/2006
Last Update Date : 08/22/2020

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Directions to “PEDIATRICS ASSOCIATES AT LICH ” Practice Location

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