# PEDIATRIC&ADOLESCENT MEDICAL CARE PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699103879
- **Authorized official:** EMAD GHALY MD (CEO)
- **Authorized official phone:** (718) 333-5483

## Contact information

- **Practice address:** 450 76TH ST, BROOKLYN, NY 11209-3204
- **Practice address phone:** (718) 333-5483
- **Practice address fax:** (718) 980-0085
- **Mailing address:** 450 76TH ST, BROOKLYN, NY 11209-3204
- **Mailing address phone:** (718) 333-5483
- **Mailing address fax:** (718) 980-0085

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2080A0000X | Pediatric Adolescent Medicine Physician | 219864 | NY | Yes |

## Other

- **Enumeration date:** 10/24/2013
- **Last updated:** 10/24/2013