NPIMap

Organization Active NPI

Pediatric Station PC

  • Primary Care Clinic/Center
  • Bronx, NY
National Provider Identifier
1275704108
Registry record updated Mar 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
F380500 Issued in NY
Legal business name
PEDIATRIC STATION PC
Practice address
3050 Grand Concourse
Bronx, NY 10458-1306
Phone
(718) 329-2275
NPI assigned
Mar 19, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2016

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

Authorized official

Name
Dr. Anastassios Kyriakakos, MDNPI 1720171119
Title
President
Phone
(718) 329-2275

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
Primary Care Clinic/Center 261QP2300X F380500 NY Primary

Addresses

Primary practice location

3050 Grand Concourse
Bronx, NY 10458-1306

Mailing address

PO Box 518
Bronxville, NY 10708-0518
Phone (718) 329-2275

National Provider Directory

National Provider Directory
Tax ID family
Pediatric Station PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1205884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459209600000",
    "number": "1275704108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 518",
            "city": "BRONXVILLE",
            "state": "NY",
            "postal_code": "107080518",
            "telephone_number": "718-329-2275",
            "fax_number": "718-329-2276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3050 GRAND CONCOURSE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104581306",
            "telephone_number": "718-329-2275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC STATION PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-19",
        "last_updated": "2016-03-29",
        "status": "A",
        "authorized_official_last_name": "KYRIAKAKOS",
        "authorized_official_first_name": "ANASTASSIOS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-329-2275",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NY",
            "license": "F380500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2016; 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.