Organization
KIDS PLUS PEDIATRICS P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY MALLAVARAPU MD (PRESIDENT)
(845) 634-8911
Entity
Organization
Contact information
Practice address
67 N MAIN ST, NEW CITY, NY 10956-3700
(845) 634-8911
Mailing address
67 N MAIN ST, NEW CITY, NY 10956-3700
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00515435
—
NY
Enumeration date
07/30/2010
Last updated
02/21/2013
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