MEDICARE: ADVANCED PEDIATRIC PRACTICE PC

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	:	1588697858
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED PEDIATRIC PRACTICE PC

Provider Business Mailing Address
First Line	:	138 BRIGHTON 11TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-5327
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	138 BRIGHTON 11TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-5327
Country	:	US
Telephone Number	:	718-332-5020
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DR. ANGELA BADINER
Credential	:	MD
Telephone Number	:	718-332-5020

Provider Enumeration Date	:	07/09/2006
Last Update Date	:	04/08/2015

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