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Organization

MMC PEDIATRICS FACULTY PRACTICE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
STEVEN SHELOV MD (CHAIRMAN, DEPARTMENT OF PEDIATRICS)
(718) 283-7500
Entity
Organization

Contact information

Practice address
948 48TH STREET, BROOKLYN, NY 11219
(718) 283-8260
(718) 283-6147
Mailing address
977 48TH ST, BROOKLYN, NY 11219-2919
(718) 283-8015
(718) 635-7235

Taxonomy

Speciality
Code
Description
License number
State
207NP0225X
Pediatric Dermatology Physician
208000000X
Pediatrics Physician
Primary
2080A0000X
Pediatric Adolescent Medicine Physician
2080P0201X
Pediatric Allergy/Immunology Physician
2080P0202X
Pediatric Cardiology Physician
2080P0206X
Pediatric Gastroenterology Physician
2080P0207X
Pediatric Hematology & Oncology Physician
2080P0208X
Pediatric Infectious Diseases Physician
2080P0210X
Pediatric Nephrology Physician
2080P0214X
Pediatric Pulmonology Physician
2080P0216X
Pediatric Rheumatology Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02064473
NY
Enumeration date
07/28/2006
Last updated
05/03/2011
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