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MMC PEDIATRICS FACULTY PRACTICE NPI 1285648154


NPI Information

NPI: 1285648154
Provider Name: MMC PEDIATRICS FACULTY PRACTICE
Classification: Pediatrics - 208000000X
Entity Type: Organization
Address:
948 48TH STREET
BROOKLYN, NY
ZIP 11219
Phone: (718) 283-8260
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MMC PEDIATRICS FACULTY PRACTICE is a pediatrics in Brooklyn, 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. MMC PEDIATRICS FACULTY PRACTICE NPI is 1285648154. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

948 48TH STREET
BROOKLYN, NY
ZIP 11219
Phone: (718) 283-8260
Fax: (718) 283-6147

The provider's authorized official is Steven Shelov .
The authorized official title is Chairman, Department Of Pediatrics and has the following contact phone number (718) 283-7500.

The enumeration date for this NPI number is 7/28/2006 and was last updated on 5/3/2011.


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
1207NP0225XDermatologyPediatric DermatologyNo
22080A0000XPediatricsAdolescent MedicineNo
32080P0201XPediatricsPediatric Allergy/ImmunologyNo
42080P0202XPediatricsPediatric CardiologyNo
52080P0206XPediatricsPediatric GastroenterologyNo
62080P0207XPediatricsPediatric Hematology-OncologyNo
72080P0208XPediatricsPediatric Infectious DiseasesNo
82080P0210XPediatricsPediatric NephrologyNo
92080P0214XPediatricsPediatric PulmonologyNo
102080P0216XPediatricsPediatric RheumatologyNo
11208000000XPediatricsYes

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
102064473MEDICAIDNEW 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: 4/28/2024

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