Organization
PM PEDIATRICS OF BAYSIDE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIELLE MARIE LOPEZ (MANAGER CREDENTIALING/ENROLLMENT)
(516) 207-7936
Entity
Organization
Contact information
Practice address
240 ATLANTIC AVE, BROOKLYN, NY 11201-5762
(516) 677-5437
(516) 673-9408
Mailing address
ONE HOLLOW LANE, LAKE SUCCESS, NY 11042
(516) 869-0650
(516) 869-0655
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
NY
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
Other
Enumeration date
07/12/2013
Last updated
01/21/2025
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