PEDIATRIC&ADOLESCENT MEDICAL CARE PLLC NPI 1699103879

NPI Information

NPI: 1699103879
Provider Name: PEDIATRIC&ADOLESCENT MEDICAL CARE PLLC
Classification: Pediatrics - 2080A0000X
Entity Type: Organization

Specialization: Adolescent Medicine

Address:
450 76TH ST
BROOKLYN, NY
ZIP 11209
Phone: (718) 333-5483
Get Directions

PEDIATRIC&ADOLESCENT MEDICAL CARE PLLC is an adolescent medicine pediatrics in Brooklyn, 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. PEDIATRIC&ADOLESCENT MEDICAL CARE PLLC NPI is 1699103879. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

450 76TH ST
BROOKLYN, NY
ZIP 11209-204
Phone: (718) 333-5483
Fax: (718) 980-0085

The provider's authorized official is Emad Ghaly .
The authorized official title is Ceo and has the following contact phone number (718) 333-5483.

The enumeration date for this NPI number is 10/24/2013 and was last updated on 10/24/2013.

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
1	2080A0000X	Pediatrics	Adolescent Medicine	219864	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	Other Provider Identifier Issuer
1	01928032	MEDICAID	NEW YORK
2	558221	MEDICARE PIN	NEW YORK
3	219864	OTHER	NEW YORK	NY LIC

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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