Organization
METROPOLITAN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDRE BROUSSARD (PROGRAM DIRECTOR)
(212) 423-7834
Entity
Organization
Contact information
Practice address
1901 1ST AVE, PEDIATRICS ROOM 523, NEW YORK, NY 10029-7404
(212) 423-7834
Mailing address
1810 3RD AVENUE, APT B2C, NEW YORK, NY 10029-6291
(646) 633-8925
Taxonomy
Speciality
Code
Description
License number
State
282NC2000X
Children's Hospital
Primary
—
—
Other
Enumeration date
08/21/2013
Last updated
08/21/2013
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