Pace Pediatric Practice PC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

210092 Issued in NY

Legal business name

PACE PEDIATRIC PRACTICE PC

Practice address

629 Eastern Pkwy
Brooklyn, NY 11213-3339

Phone

(718) 771-8435

NPI assigned

Feb 9, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Bolanle Olajide, MD

Title

President

Phone

(718) 771-8435

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1801937099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "657 E 26TH ST APT 1U",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112102170",
            "telephone_number": "718-421-4246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 EASTERN PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112133339",
            "telephone_number": "718-771-8435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACE PEDIATRIC PRACTICE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "OLAJIDE",
        "authorized_official_first_name": "BOLANLE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-771-8435",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "210092",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0187839",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Steven Michael Paccione, MD
• Pace Cardiology PC
• Pace Medical Supply
• Pace Medical Supply LLC
• Pace Neuro PC
• Ellen S. Pace, LMHC,CCC,MS
• John Pace, D.P.M
• John Louis Pace, DPM
• Kelcie Pace
• Leonard Angelo Pace

• Pediatrics Physician in Brooklyn, NY
• Providers in Brooklyn, 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 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.