Organization
MEDIKIDS PEDIATRICS MEDICINE II PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARCIAL JIMENEZ M.D. (PEDIATRICIAN)
(718) 220-2804
Entity
Organization
Contact information
Practice address
320 E 188TH ST, BRONX, NY 10458-5402
(718) 220-2804
(718) 220-5321
Mailing address
320 E 188TH ST, BRONX, NY 10458-5402
(718) 220-2804
(718) 220-5321
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02218124
—
NY
Enumeration date
08/07/2007
Last updated
06/13/2016
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