NPIMap

Organization Active NPI

Eastern Pediatrics,P.C.

  • Pediatrics Physician
  • Dix Hills, NY
National Provider Identifier
1326335068
Registry record updated Jul 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
193569 Issued in NY
Legal business name
EASTERN PEDIATRICS,P.C.
Practice address
40 Candlewood Path
Dix Hills, NY 11746
Phone
(631) 462-2240
NPI assigned
Jul 1, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2011

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

Authorized official

Name
Maryann Agbim
Title
Office Manager
Phone
(631) 462-2440

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208000000X 193569 NY Primary

Addresses

Primary practice location

40 Candlewood Path
Dix Hills, NY 11746

Mailing address

40 Candlewood Path
Dix Hills, NY 11746-5306
Phone (631) 462-2440

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1309478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309478400000",
    "number": "1326335068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 CANDLEWOOD PATH",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117465306",
            "telephone_number": "631-462-2440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 CANDLEWOOD PATH",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "11746",
            "telephone_number": "631-462-2240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN PEDIATRICS,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-01",
        "last_updated": "2011-07-01",
        "status": "A",
        "authorized_official_last_name": "AGBIM",
        "authorized_official_first_name": "MARYANN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "631-462-2440"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "193569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dix Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2011; 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.