Pediatric Station PC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

PEDIATRIC STATION PC

Practice address

3050 Grand Concourse
Bronx, NY 10458

Phone

(718) 329-2275

Fax

(718) 329-2276

NPI assigned

Sep 30, 2006

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

Anastassios Kyriakakos, MDNPI 1720171119

Title

President

Phone

(718) 329-2275

Specialties & licenses 1

Addresses

Tax ID family

Pediatric Station PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Pediatric Station PC

  • Primary Care Clinic/Center
  • Bronx, NY
  • NPI 1275704108
  NPD tax ID

Practitioners 2

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.

• Anastassios Kyriakakos, MD

  • Pediatrics Physician
  • Bronx, NY
  • NPI 1720171119
  NPD (past) Authorized official
• Betsy Negron, CPNP

  • Pediatric Nurse Practitioner
  • Bronx, NY
  • NPI 1790148799
  NPD (past)

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

{
    "created_epoch": "1159574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1922191311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 518",
            "city": "BRONXVILLE",
            "state": "NY",
            "postal_code": "107080518",
            "telephone_number": "718-239-2275",
            "fax_number": "718-329-2276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3050 GRAND CONCOURSE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10458",
            "telephone_number": "718-329-2275",
            "fax_number": "718-329-2276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC STATION PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KYRIAKAKOS",
        "authorized_official_first_name": "ANASTASSIOS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-329-2275",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Swetha Pedavally, M.D
• Nikhil Chowdary Peddi
• Ann Louise Pedersen, MD
• Pediatric Associates of North Riverdale, P.C.
• Pediatric Station PC
• Solimar Pedraza-Negron, MD
• Daniel Pedraza, LCSW-R
• Ivelisse Marie Pedreira Garcia
• Susana Paula Pedro, CRNA
• Melissa Pedroza, PSYD

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