Organization Active NPI

Metropolitan Pediatric Neurology PC

  • Pediatrics Physician
  • Great Neck, NY
National Provider Identifier
1295859403
Registry record updated Oct 22, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
METROPOLITAN PEDIATRIC NEUROLOGY PC
Practice address
1000 Northern Blvd
Suite 240
Great Neck, NY 11021-5312
Phone
(516) 829-3100
NPI assigned
Mar 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2007

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

Authorized official

Name
Mrs. Elisa Press
Title
Office MGR
Phone
(516) 829-3100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

1000 Northern Blvd
Suite 240
Great Neck, NY 11021-5312

Mailing address

1000 Northern Blvd
Suite 240
Great Neck, NY 11021-5312

Other identifiers 1

IdentifierTypeStateIssuer
00845881MedicaidNY

National Provider Directory

National Provider Directory

Locations

1000 Northern Blvd
Ste 240
Great Neck, NY 11021
Phone (516) 829-0802

1000 Northern Blvd
Ste 2
Great Neck, NY 11021
Phone (516) 829-3100

NPI Registry JSON

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193011200000",
    "number": "1295859403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 NORTHERN BLVD",
            "address_2": "SUITE 240",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110215312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 NORTHERN BLVD",
            "address_2": "SUITE 240",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110215312",
            "telephone_number": "516-829-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METROPOLITAN PEDIATRIC NEUROLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-16",
        "last_updated": "2007-10-22",
        "status": "A",
        "authorized_official_last_name": "PRESS",
        "authorized_official_first_name": "ELISA",
        "authorized_official_title_or_position": "OFFICE MGR",
        "authorized_official_telephone_number": "516-829-3100",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00845881",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2007; 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.