Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
WYCKOFF PEDIATRIC CARE CENTER
Inactive
Organization
WYCKOFF PEDIATRIC CARE CENTER
Inactive
Parent organization
WYCKOFF PROFESSIONAL MEDICAL SERVICES PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
WYCKOFF PROFESSIONAL MEDICAL SERVICES PC
Authorized official
VALI GACHE (CHIEF FINANCIAL OFFICER)
(718) 240-1795
Entity
Organization
Contact information
Practice address
1411 MYRTLE AVE, 1411 MYRTLE AVENUE, BROOKLYN, NY 11237-4512
(718) 907-4301
(718) 919-1309
Mailing address
1411 MYRTLE AVE, WYCKOFF PEDIATRIC CARE CENTER, BROOKLYN, NY 11237-4512
(718) 907-4301
(718) 919-1309
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03722025
—
NY
Enumeration date
01/29/2014
Last updated
04/02/2019
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up