I M Pediatrics PC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

217951 Issued in NY

Legal business name

I M PEDIATRICS PC

Practice address

6412 Fresh Pond Rd
Ridgewood, NY 11385-3331

Phone

(718) 497-1565

Fax

(718) 497-1567

NPI assigned

Nov 30, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Iwona Katarzyna Mienko, MDNPI 1609140334

Title

President

Phone

(718) 497-1565

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Iwona K Mienko, MD

  • Pediatrics Physician
  • Ridgewood, NY
  • NPI 1609140334
  NPD (past) Authorized official

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330041600000",
    "number": "1669456984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6412 FRESH POND RD",
            "city": "RIDGEWOOD",
            "state": "NY",
            "postal_code": "113853331",
            "telephone_number": "718-497-1565",
            "fax_number": "718-497-1567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6412 FRESH POND RD",
            "city": "RIDGEWOOD",
            "state": "NY",
            "postal_code": "113853331",
            "telephone_number": "718-497-1565",
            "fax_number": "718-497-1567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "I M PEDIATRICS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-30",
        "last_updated": "2012-02-24",
        "status": "A",
        "authorized_official_last_name": "MIENKO",
        "authorized_official_first_name": "IWONA",
        "authorized_official_middle_name": "KATARZYNA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-497-1565",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "217951",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02105622",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chin-Chee Hu, DDS
• Sierra Hubsher
• Ae Sol Hwang
• Yu-Jen Hwang, D.P.T.
• Hyun J Kim Physical Therapy PC
• I&Y Pharmacy Corp
• Rachel Ibarreta, PT
• Peter Ibrahim, OTR/L
• Clement Enorense Idehen, O.D
• Virginia V Ilie, NP

• Pediatrics Physician in Ridgewood, NY
• Providers in Ridgewood, 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 Feb 24, 2012; 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.