Organization
ADVANCED PEDIATRICS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILFREDO LAO M.D. (PARTNER)
(718) 271-2600
Entity
Organization
Contact information
Practice address
9436 59TH AVE, SUITE C4, ELMHURST, NY 11373-5151
(718) 271-2600
(718) 271-2766
Mailing address
9436 59TH AVE, SUITE C4, ELMHURST, NY 11373-5151
(718) 271-2600
(718) 271-2766
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
211204
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01860195
—
NY
05
—
01922430
—
NY
Enumeration date
05/31/2007
Last updated
02/23/2012
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