NPIMap

Organization Active NPI

Kids First Pediatrics, PC

  • Pediatrics Physician
  • Port Jefferson Station, NY
National Provider Identifier
1629258033
Registry record updated May 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
164113 Issued in NY
Legal business name
KIDS FIRST PEDIATRICS, PC
Practice address
815 Hallock Ave
Suite a
Port Jefferson Station, NY 11776-1220
Phone
(631) 331-7267
Fax
(631) 331-7289
NPI assigned
Nov 14, 2007
Last updated
May 19, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2008

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

Authorized official

Name
Damian Forletti, M.D.NPI 1689640690
Title
Physician
Phone
(631) 331-7267

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 164113 NY Primary

Addresses

Primary practice location

815 Hallock Ave
Suite a
Port Jefferson Station, NY 11776-1220

Mailing address

815 Hallock Ave
Suite a
Port Jefferson Station, NY 11776-1220
Phone (631) 331-7267

National Provider Directory

National Provider Directory

Locations

815 Hallock Ave
Ste A
Port Jefferson Station, NY 11776
Phone (631) 331-7267

Practitioners & affiliated clinicians

Practitioners 1

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": "1194998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211155200000",
    "number": "1629258033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 HALLOCK AVE",
            "address_2": "SUITE A",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761220",
            "telephone_number": "631-331-7267",
            "fax_number": "631-331-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 HALLOCK AVE",
            "address_2": "SUITE A",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761220",
            "telephone_number": "631-331-7267",
            "fax_number": "631-331-7289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDS FIRST PEDIATRICS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-14",
        "last_updated": "2008-05-19",
        "status": "A",
        "authorized_official_last_name": "FORLETTI",
        "authorized_official_first_name": "DAMIAN",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "631-331-7267",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "164113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jefferson Station, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2008; 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.