NPIMap

Organization Active NPI

Eckerson Pediatric Associates, PC

Doing business as Clarkstown Pediatrics

  • Specialist
  • Nanuet, NY
National Provider Identifier
1689856098
Registry record updated Nov 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
ECKERSON PEDIATRIC ASSOCIATES, PC
Doing business as
Clarkstown Pediatrics
Practice address
35 Smith St
Nanuet, NY 10954-2914
Phone
(845) 623-7100
Fax
(845) 732-8440
NPI assigned
Nov 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2007

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

Authorized official

Name
Elliot J Siegal, M.D.NPI 1710051446
Title
President
Phone
(845) 352-5511

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

35 Smith St
Nanuet, NY 10954-2914

Mailing address

35 Smith St
Nanuet, NY 10954-2914
Phone (845) 623-7100

Other identifiers 1

IdentifierTypeStateIssuer
00515637MedicaidNY

Other names 1

  • CLARKSTOWN PEDIATRICS Doing business as

National Provider Directory

National Provider Directory

Locations

35 Smith St
Nanuet, NY 10954
Phone (845) 623-7100

Practitioners & affiliated clinicians

Practitioners 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1196208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196208000000",
    "number": "1689856098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 SMITH ST",
            "city": "NANUET",
            "state": "NY",
            "postal_code": "109542914",
            "telephone_number": "845-623-7100",
            "fax_number": "845-732-8440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 SMITH ST",
            "city": "NANUET",
            "state": "NY",
            "postal_code": "109542914",
            "telephone_number": "845-623-7100",
            "fax_number": "845-732-8440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ECKERSON PEDIATRIC ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-28",
        "last_updated": "2007-11-28",
        "status": "A",
        "authorized_official_last_name": "SIEGAL",
        "authorized_official_first_name": "ELLIOT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "845-352-5511",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00515637",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CLARKSTOWN PEDIATRICS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Nanuet, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2007; 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.