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PREFERRED PEDIATRICS OF ROCKLAND LLC NPI 1063568053


NPI Information

NPI: 1063568053
Provider Name: PREFERRED PEDIATRICS OF ROCKLAND, LLC
Classification: Specialist - 174400000X
Entity Type: Organization

CLIA Number: 33D0141173

Address:
100 ROUTE 59
SUITE 104
SUFFERN, NY
ZIP 10901
Phone: (845) 357-5020
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PREFERRED PEDIATRICS OF ROCKLAND, LLC is a specialist in Suffern, NY. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. PREFERRED PEDIATRICS OF ROCKLAND, LLC NPI is 1063568053. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

100 ROUTE 59
SUITE 104
SUFFERN, NY
ZIP 10901-927
Phone: (845) 357-5020
Fax: (845) 357-5033

The provider's authorized official is Richard Sirop .
The authorized official title is Delegated Official and has the following contact phone number (845) 357-5020.

The CLIA number assigned to this NPI record is 33D0141173 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/25/2007 and was last updated on 4/20/2008.


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:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1174400000XSpecialist100063NEW YORKYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
17868161OTHERNEW YORKAETNA PPO GROUP #
2=========OTHERNEW YORKTAX ID#
30048210OTHERNEW YORKAETNA HMO GROUP#

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.