MEDICARE: TRIBECA PEDIATRICS

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
1	208000000X	Pediatrics Physician

General Provider Information

NPI Number	:	1356000160
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRIBECA PEDIATRICS

Provider Business Mailing Address
First Line	:	11 PARK PL STE 1200
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10007-2823
Country	:	US
Telephone Number	:	212-226-7666
Fax Number	:	929-888-9562

Provider Business Practice Location Address
First Line	:	9 MCWILLIAMS PL
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07302-1609
Country	:	US
Telephone Number	:	212-226-7666
Fax Number	:

Authorized Official
Title or Position	:	CREDENTIALING COORDINATOR
Name	:	CARMEN DELIA HENRIQUEZ
Credential	:
Telephone Number	:	212-226-7666

Provider Enumeration Date	:	12/09/2021
Last Update Date	:	11/29/2023

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Directions to “TRIBECA PEDIATRICS ” Practice Location

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