BOSTON PEDIATRICS PLLC NPI 1275724767

NPI Information

  • NPI: 1275724767
  • Provider Name: BOSTON PEDIATRICS, PLLC
  • Classification: Pediatrics - 208000000X
  • Entity Type: Organization
  • Former Legal Business Name: BOSTON ROAD PEDIATRICS, PC
  • CLIA Number: 33D0995890
  • Address: 1262 BOSTON RD
    SUITE 1
    BRONX, NY
    ZIP 10456
  • Phone: (718) 617-2500

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NPI Details

BOSTON PEDIATRICS, PLLC is a pediatrics in Bronx, NY. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. BOSTON PEDIATRICS, PLLC NPI is 1275724767. The provider is registered as an organization entity type and is a single specialty group.
The provider Former Legal Business Name Is Boston Road Pediatrics, Pc.

The provider's business location address is:

1262 BOSTON RD
SUITE 1
BRONX, NY
ZIP 10456-602
Phone: (718) 617-2500
Fax: (718) 617-0500

The provider's authorized official is Jorge Luis Cornielle .
The authorized official title is Medical Doctor and has the following contact phone number (718) 617-2500.

The CLIA number assigned to this NPI record is 33D0995890 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/8/2007 and was last updated on 1/31/2013.

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
1208000000XPediatrics214716NEW 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
102087341MEDICAIDNEVADA
202269730MEDICAIDNEW YORK
303426235MEDICAIDNEW YORK
403305057MEDICAIDNEW 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: 11/21/2025

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