Organization
JUNCTION BLVD PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA MARTORELL FOX (DIRECTOR OFFICER)
(718) 899-4302
Entity
Organization
Contact information
Practice address
4036 JUNCTION BLVD, CORONA, NY 11368-2122
(718) 899-4302
Mailing address
4036 JUNCTION BLVD, CORONA, NY 11368-2122
(718) 899-4302
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
104917
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00182614
—
NY
Enumeration date
12/11/2006
Last updated
08/22/2020
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