Pediatric Neurology PC

Primary specialty

Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X

License

259249 Issued in NY

Legal business name

PEDIATRIC NEUROLOGY PC

Practice address

210 N Central Ave Ste 250
Hartsdale, NY 10530-1949

Phone

(914) 358-1162

Fax

(914) 368-8343

NPI assigned

Aug 16, 2016

Organization subpart

No

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

Authorized official

Name

Maja Ilic, MDNPI 1255652863

Title

MD

Phone

(914) 358-1162

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Maja Ilic, M.D.

  • Neurology Physician
  • Hartsdale, NY
  • NPI 1255652863

  Multi-Specialty

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1471305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693526400000",
    "number": "1124573522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 MURRAY HILL RD",
            "city": "SCARSDALE",
            "state": "NY",
            "postal_code": "105832804",
            "telephone_number": "914-358-1162",
            "fax_number": "914-368-8343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 N CENTRAL AVE STE 250",
            "city": "HARTSDALE",
            "state": "NY",
            "postal_code": "105301949",
            "telephone_number": "914-358-1162",
            "fax_number": "914-368-8343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC NEUROLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-16",
        "last_updated": "2023-09-01",
        "certification_date": "2023-09-01",
        "status": "A",
        "authorized_official_last_name": "ILIC",
        "authorized_official_first_name": "MAJA",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "914-358-1162",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "NY",
            "license": "259249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Pawell
• Eryn Mary Payne, LCSW
• Bre'on Payton, MD
• Seth Douglas Pearl, DC
• Stacie Pearl, CCC-SLP
• Lisa Penberthy, LMSW
• Pepa Psychological Services, P.C.
• Lauren Pepa, PH.D., BCBA
• Heather Perlow
• David Pernick

• Neurology with Special Qualifications in Child Neurology Physician in Hartsdale, NY
• Providers in Hartsdale, NY by specialty
• Neurology with Special Qualifications in Child Neurology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.