MEDICARE: LAGUARDIA PLACE PEDIACTRICS, 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	:	1861608747
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAGUARDIA PLACE PEDIACTRICS, PC

Provider Business Mailing Address
First Line	:	505 LAGUARDIA PL
Second Line	:	L-3
City	:	NEW YORK
State	:	NY
Zip	:	10012-2001
Country	:	US
Telephone Number	:	212-505-0222
Fax Number	:	212-505-1091

Provider Business Practice Location Address
First Line	:	505 LAGUARDIA PL
Second Line	:	L-3
City	:	NEW YORK
State	:	NY
Zip	:	10012-2001
Country	:	US
Telephone Number	:	212-505-0222
Fax Number	:	212-505-1091

Authorized Official
Title or Position	:	PEDIATRICIAN
Name	:	DR. VICKI ANNE PAPADEAS
Credential	:	MD
Telephone Number	:	212-505-0222

Provider Enumeration Date	:	05/15/2007
Last Update Date	:	08/22/2020

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Practice Location Address:

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Practice Fax:

1275619595 — VICKI ANNE PAPADEAS MD
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1134343528 — DR. ELISABETH HOLMES SERRA MD
Practice Location Address:

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1881810588 — DR. MIKAL RACHEL FINKELSTEIN M.D.
Practice Location Address:

505 LAGUARDIA PL , SUITE L3
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1477762391 — DR. LOIS ANN JACKSON D.D.S.
Practice Location Address:

505 LAGUARDIA PL , L4
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1073508933 — MR. SEBASTIAN LATTUGA MD FACOS
Practice Location Address:

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