Organization
PM PEDIATRICS OF STATEN ISLAND
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
2407 RICHMOND AVE, STATEN ISLAND, NY 10314-3906
(718) 698-5437
(718) 698-5444
Mailing address
1 HOLLOW LN, NEW HYDE PARK, NY 11042-1220
(516) 869-0650
(516) 869-0655
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
NY
261QU0200X
Urgent Care Clinic/Center
—
—
Other
Enumeration date
03/08/2016
Last updated
01/21/2025
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