INDO AMERICAN PEDIATRICS P.C NPI 1073888954

NPI Information

  • NPI: 1073888954
  • Provider Name: INDO AMERICAN PEDIATRICS P.C
  • Classification: Nurse Practitioner - 363LP0200X
  • Specialization: Pediatrics
  • Entity Type: Organization
  • CLIA Number: 33D0998139
  • Address: 8020 BROADWAY
    SUITE 1F
    ELMHURST, NY
    ZIP 11373
  • Phone: (718) 396-9643

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NPI Details

INDO AMERICAN PEDIATRICS P.C is a pediatrics nurse practitioner in Elmhurst, NY. INDO AMERICAN PEDIATRICS P.C NPI is 1073888954. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

8020 BROADWAY
SUITE 1F
ELMHURST, NY
ZIP 11373
Phone: (718) 396-9643
Fax: (718) 396-9645

The provider's authorized official is Lyudmila Sorkin .
The authorized official title is Nurse Practitioner and has the following contact phone number (718) 396-9643.

The CLIA number assigned to this NPI record is 33D0998139 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/12/2012 and was last updated on 3/12/2012.

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:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP0200XNurse PractitionerPediatricsF381862NEW 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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
100246075MEDICAIDNEW YORK

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: 3/30/2025

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