South Queens Pediatric Assoc, LLP

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

SOUTH QUEENS PEDIATRIC ASSOC, LLP

Practice address

13124 Rockaway Blvd
South Ozone Park, NY 11420-2932

Phone

(718) 659-7166

Fax

(718) 529-5930

NPI assigned

Sep 28, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Jamil M Abraham, M.D.

Title

Medical Director

Phone

(718) 659-7166

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1437241775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13124 ROCKAWAY BLVD",
            "city": "SOUTH OZONE PARK",
            "state": "NY",
            "postal_code": "114202932",
            "telephone_number": "718-659-7166",
            "fax_number": "718-529-5930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13124 ROCKAWAY BLVD",
            "city": "SOUTH OZONE PARK",
            "state": "NY",
            "postal_code": "114202932",
            "telephone_number": "718-659-7166",
            "fax_number": "718-529-5930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH QUEENS PEDIATRIC ASSOC, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ABRAHAM",
        "authorized_official_first_name": "JAMIL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "718-659-7166",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shireese Sookram, RN
• Shirelle Sookram, RN
• South Queens Acupucture, P.C.
• South Queens Imaging P C
• South Queens Medical Group PLLC
• Tina Souverain, LMSW
• Vera Spektor, MSW
• Sreenidhi Pharma Inc (Abrin Pharmacy)
• Start Where You Stand, Inc.
• Godfrey Stewart

• Pediatrics Physician in South Ozone Park, NY
• Providers in South Ozone Park, NY by specialty
• Pediatrics Physician in New York

• 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.