Organization
EXTRAORDINARY PEDIATRICS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BEATA JALOWSKI (REVENUE CYCLE MANAGER)
(718) 819-2830
Entity
Organization
Contact information
Practice address
5 DAKOTA DR STE 200, NEW HYDE PARK, NY 11042-1109
(516) 621-2681
(516) 621-2403
Mailing address
5 DAKOTA DR STE 200, NEW HYDE PARK, NY 11042-1109
(516) 621-2681
(516) 621-2403
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
106S00000X
Behavior Technician
—
—
208000000X
Pediatrics Physician
—
—
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary
—
—
246Q00000X
Pathology Specialist/Technologist
—
—
251E00000X
Home Health Agency
—
NY
Other
Enumeration date
07/02/2008
Last updated
06/27/2023
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