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Organization

ISLAND PEDIATRICS, P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BRIAN ROBERT MCMAHON M.D. (PRESIDENT)
(719) 390-0400
Entity
Organization

Contact information

Practice address
125 SLOSSON AVE, STATEN ISLAND, NY 10314-2517
(718) 390-0400
(718) 390-0566
Mailing address
125 SLOSSON AVE, STATEN ISLAND, NY 10314-2517
(718) 390-0400
(718) 390-0566

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
168902
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01848993
NY
Enumeration date
10/17/2012
Last updated
10/17/2012
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