MADISON IRVING PEDIATRICS PC NPI 1063576312

NPI Information

MADISON IRVING PEDIATRICS, PC is an adolescent medicine pediatrics in Syracuse, NY. The provider is a pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. MADISON IRVING PEDIATRICS, PC NPI is 1063576312. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

475 IRVING AVE
SUITE 210
SYRACUSE, NY
ZIP 13210-756
Phone: (315) 471-2646
Fax: (315) 471-1762

The provider's authorized official is Kathleen Shefner .
The authorized official title is Owner and has the following contact phone number (315) 471-2646.

The CLIA number assigned to this NPI record is 33D0166138 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/21/2006 and was last updated on 1/26/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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