BDF Pediatric Group LLP

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

208922 Issued in NY

Legal business name

BDF PEDIATRIC GROUP LLP

Practice address

2647 Coney Island Ave
Brooklyn, NY 11223-5502

Phone

(718) 891-1551

Fax

(718) 368-1177

NPI assigned

May 31, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Lilya Darevskaya, D.O

Title

Provider

Phone

(718) 891-1551

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1180569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1265633598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2647 CONEY ISLAND AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112235502",
            "telephone_number": "718-891-1551",
            "fax_number": "718-368-1177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2647 CONEY ISLAND AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112235502",
            "telephone_number": "718-891-1551",
            "fax_number": "718-368-1177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BDF PEDIATRIC GROUP LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DAREVSKAYA",
        "authorized_official_first_name": "LILYA",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "718-891-1551",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "D.O"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "208922",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01884293",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01844504",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.