Child Care Pediatrics, P.C.
Organization Active NPI Specialist · Glendale, NY
NPI 1255580445 · NPPES record last updated Sep 12, 2008
Key facts
- NPI
- 1255580445
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Specialist 174400000X
- License
- 215450 (NY)
- Legal business name
- CHILD CARE PEDIATRICS, P.C.
- Practice address
- 6553 Myrtle Ave
Glendale, NY 11385-7028 - Phone
- (718) 366-5391
- Fax
- (718) 418-3367
- NPI assigned
- Sep 12, 2008
- Organization subpart
- No
Authorized official
- Name
- Dr. Eleonora Mezheritsky, M.D.
- Title
- Vice President
- Phone
- (917) 463-6581
Practitioners 1
-
Eleonora Mezheritsky, M.D.
National Provider Directory
Locations
6553 Myrtle Ave
Glendale, NY 11385
Phone (718) 366-5391
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist |
174400000X | 215450 | NY | Yes |
Addresses
Primary practice location
6553 Myrtle Ave
Glendale, NY 11385-7028
Mailing address
6553 Myrtle Ave
Glendale, NY 11385-7028
Phone (718) 366-5391
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02271621 | Medicaid | NY |
Other providers in Glendale, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 12, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.