ISLAND KIDS PEDIATRICS P.C. NPI 1487792024

NPI Information

NPI: 1487792024
Provider Name: ISLAND KIDS PEDIATRICS, P.C.

Former Legal Business Name: DENIZ CEREB MD PC

Classification: Pediatrics - 2080A0000X
Entity Type: Organization

Specialization: Adolescent Medicine

Address:
2066 RICHMOND AVENUE
1ST FLOOR
STATEN ISLAND, NY
ZIP 10314
Phone: (718) 982-9001
Get Directions

ISLAND KIDS PEDIATRICS, P.C. is an adolescent medicine pediatrics in Staten Island, 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. ISLAND KIDS PEDIATRICS, P.C. NPI is 1487792024. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Deniz Cereb Md Pc.

The provider's business location address is:

2066 RICHMOND AVENUE
1ST FLOOR
STATEN ISLAND, NY
ZIP 10314-916
Phone: (718) 982-9001
Fax: (718) 982-9008

The provider's authorized official is Deniz Cereb .
The authorized official title is President and has the following contact phone number (718) 982-9001.

The CLIA number assigned to this NPI record is 33D0970208 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/4/2007 and was last updated on 8/2/2010.

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
1	261QP2300X	Clinic/Center	Primary Care	200270	NEW YORK	No
2	2080A0000X	Pediatrics	Adolescent Medicine	200270	NEW YORK	Yes

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
1	03120101	MEDICAID	NEW YORK
2	01717335	MEDICAID	NEW YORK
3	F67680	MEDICARE UPIN	NEW 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

NPI Synchronization or Removal

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