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Organization
PEDIATRICS 2000AT 207 STREET PLLC
Active
Organization
PEDIATRICS 2000AT 207 STREET PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JUAN TAPIA MENDOZA MD (OWNER)
(212) 544-7777
Entity
Organization
Contact information
Practice address
515 W 207TH ST, NEW YORK, NY 10034-2645
(212) 544-7777
(212) 544-9660
Mailing address
515 W 207TH ST, NEW YORK, NY 10034-2645
(212) 544-7777
(212) 544-9660
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
—
NULL
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
—
—
Other
Enumeration date
03/26/2007
Last updated
02/08/2008
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