Organization
PONDVIEW PEDIATRICS LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THEODORE DONALD CLOSE MD (GENERAL PARTNER)
(518) 477-8761
Entity
Organization
Contact information
Practice address
77 MILLER RD, SUITE 1, CASTLETON, NY 12033
(518) 477-8761
(518) 477-2251
Mailing address
77 MILLER RD, SUITE 1, CASTLETON, NY 12033
(518) 477-8761
(518) 477-2251
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01266779
—
NY
Enumeration date
08/24/2006
Last updated
08/22/2020
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