Organization
CHILD CARE PEDIATRICS, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELEONORA MEZHERITSKY M.D. (VICE PRESIDENT)
(917) 463-6581
Entity
Organization
Contact information
Practice address
6553 MYRTLE AVE, GLENDALE, NY 11385-7028
(718) 366-5391
(718) 418-3367
Mailing address
6553 MYRTLE AVE, GLENDALE, NY 11385-7028
(718) 366-5391
(718) 418-3367
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
215450
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02271621
—
NY
Enumeration date
09/12/2008
Last updated
09/12/2008
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