NPIMap

Organization Active NPI

Boro Park Pediatric Associates, PLLC

  • Pediatrics Physician
  • Brooklyn, NY
National Provider Identifier
1063629186
Registry record updated Jul 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
BORO PARK PEDIATRIC ASSOCIATES, PLLC
Practice address
4406 12TH Ave
Brooklyn, NY 11219-2077
Phone
(718) 438-4400
Fax
(718) 438-4404
NPI assigned
May 17, 2007
Last updated
Jul 3, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. David DiamondNPI 1255388674
Title
Ceo
Phone
(718) 438-4400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X Primary

Addresses

Primary practice location

4406 12TH Ave
Brooklyn, NY 11219-2077

Mailing address

4406 12TH Ave
Brooklyn, NY 11219-2077
Phone (718) 438-4400

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372809600000",
    "number": "1063629186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4406 12TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112192077",
            "telephone_number": "718-438-4400",
            "fax_number": "718-438-4404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4406 12TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112192077",
            "telephone_number": "718-438-4400",
            "fax_number": "718-438-4404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BORO PARK PEDIATRIC ASSOCIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2013-07-03",
        "status": "A",
        "authorized_official_last_name": "DIAMOND",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "718-438-4400",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.