Old Country Pediatrics PC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

181879 Issued in NY

Legal business name

OLD COUNTRY PEDIATRICS PC

Practice address

556 Old Country Rd
Plainview, NY 11803

Phone

(516) 938-3232

NPI assigned

Sep 2, 2006

Organization subpart

No

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

Authorized official

Name

Charles L Bruzzone, MDNPI 1750444287

Title

President

Phone

(516) 938-3232

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

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

• Charles Bruzzone, MD

  • Pediatrics Physician
  • Plainview, NY
  • NPI 1750444287
  NPD (past) Authorized official
• Paul Muscarello, MD

  • Pediatrics Physician
  • Plainview, NY
  • NPI 1497837793
  NPD (past)

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

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1184726960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "556 OLD COUNTRY RD",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "11803",
            "telephone_number": "516-938-3232",
            "fax_number": "516-938-8443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "556 OLD COUNTRY RD",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "11803",
            "telephone_number": "516-938-3232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLD COUNTRY PEDIATRICS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BRUZZONE",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-938-3232",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "181879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Suyoun Oh
• Blanka Oh, LCSW, CCM
• Chinyere T Ohadoma Sr.
• Jonathan Ohebsion, M.D.
• Maria Olavarria, M.S. ED
• Idania Oliva, RPH
• Arlene Oliver
• Lisa Ann Olsen, CCC-SLP
• Olsl New York Operating Company LLC
• Crispin Ong, MD

• Pediatrics Physician in Plainview, NY
• Providers in Plainview, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.