NPIMap

Organization Active NPI

West 11 Street Pediatrics

  • Pediatrics Physician
  • New York, NY
National Provider Identifier
1609994748
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
WEST 11 STREET PEDIATRICS
Practice address
46 W 11TH St
New York, NY 10011-8602
Phone
(212) 529-4330
NPI assigned
Mar 27, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Edit Polyakova
Title
Billing Manager
Phone
(212) 529-4330

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X NU Primary

Addresses

Primary practice location

46 W 11TH St
New York, NY 10011-8602

Mailing address

46 West 11 Street
New York, NY 10011

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1609994748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 WEST 11 STREET",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 W 11TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100118602",
            "telephone_number": "212-529-4330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST 11 STREET PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "POLYAKOVA",
        "authorized_official_first_name": "EDIT",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "212-529-4330",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • 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.