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Organization

SPRINGFIELD PEDIATRIC P. C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
HABIB NAZARIAN M.D. (OFFICER)
(718) 712-2200
Entity
Organization

Contact information

Practice address
23520 147TH AVE STE 4, ROSEDALE, NY 11422-3293
(718) 712-2200
(718) 712-5666
Mailing address
23520 147TH AVENUE, SUITE 4, ROSEDALE, NY 11422
(718) 712-2200
(718) 712-5666

Taxonomy

Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
Primary
142782
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00731035
NY
Enumeration date
10/10/2006
Last updated
08/19/2011
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