Queens Pediatric Cardiology, PC

Primary specialty

Pediatric Cardiology PhysicianTaxonomy code 2080P0202X

License

234477 Issued in NY

Legal business name

QUEENS PEDIATRIC CARDIOLOGY, PC

Practice address

8708 Justice Ave
Suite CF
Elmhurst, NY 11373-4590

Phone

(718) 565-0700

NPI assigned

Jan 24, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Damodar Thambireddy, MD

Title

Sole Proprietor

Phone

(718) 565-0700

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239321600000",
    "number": "1710032453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8708 JUSTICE AVE",
            "address_2": "SUITE CF",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113734590",
            "telephone_number": "718-565-0700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8708 JUSTICE AVE",
            "address_2": "SUITE CF",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113734590",
            "telephone_number": "718-565-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUEENS PEDIATRIC CARDIOLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-24",
        "last_updated": "2009-04-10",
        "status": "A",
        "authorized_official_last_name": "THAMBIREDDY",
        "authorized_official_first_name": "DAMODAR",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "718-565-0700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "NY",
            "license": "234477",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02624133",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Cardiology Physician in Elmhurst, NY
• Providers in Elmhurst, NY by specialty
• Pediatric Cardiology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2009; 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.