| National Pediatric Md Pc | |
|
10211 Roosevelt Ave Corona NY 11368-2331 | |
| (718) 898-5200 | |
| (718) 898-1251 |
| Full Name | National Pediatric Md Pc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 10211 Roosevelt Ave, Corona, New York |
| Authorized Official Name and Position | Hector Bienvenido Florimon De La Rosa (MEDICAL DIRECTOR) |
| Authorized Official Contact | 7188985200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| National Pediatric Md Pc 10211 Roosevelt Ave Corona NY 11368-2331 Ph: (718) 898-5200 | National Pediatric Md Pc 10211 Roosevelt Ave Corona NY 11368-2331 Ph: (718) 898-5200 |
| NPI Number | 1740492347 |
|---|---|
| Provider Enumeration Date | 05/04/2007 |
| Last Update Date | 04/07/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740492347 | NPI | - | NPPES |
| 01455449 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 189653 (New York) | Primary |
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