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SPECIALIST PEDS AT LICH NPI 1922055045


NPI Information

NPI: 1922055045
Provider Name: SPECIALIST PEDS AT LICH
Classification: Pediatrics - 2080P0206X
Entity Type: Organization

Specialization: Pediatric Gastroenterology

Address:
97 AMITY ST
BROOKLYN, NY
ZIP 11201
Phone: (718) 780-1025
Get Directions

SPECIALIST PEDS AT LICH is a pediatric gastroenterology pediatrics in Brooklyn, NY. The provider is a pediatrician who specializes in the diagnosis and treatment of diseases of the digestive systems of infants, children and adolescents. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using lighted scopes to see internal organs. SPECIALIST PEDS AT LICH NPI is 1922055045. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

97 AMITY ST
BROOKLYN, NY
ZIP 11201-004
Phone: (718) 780-1025

The provider's authorized official is Steven Schwarz .
The authorized official title is Managing Employee and has the following contact phone number (718) 780-1025.

The enumeration date for this NPI number is 5/27/2006 and was last updated on 8/22/2020.


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
12080P0206XPediatricsPediatric GastroenterologyYes
2207N00000XDermatologyX
32080A0000XPediatricsAdolescent MedicineX
42080P0207XPediatricsPediatric Hematology-OncologyX
52080P0205XPediatricsPediatric EndocrinologyX

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
102123191MEDICAIDNEW 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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