Organization
CONCOURSE PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUAN J PILARTE M.D. (PRESIDENT)
(718) 293-3566
Entity
Organization
Contact information
Practice address
1001 GRAND CONCOURSE APT 1E, BRONX, NY 10452-9122
(718) 293-3566
(718) 293-3547
Mailing address
1001 GRAND CONCOURSE APT 1E, BRONX, NY 10452-9122
(718) 293-3566
(718) 293-3547
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
199747
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01596501
—
NY
Enumeration date
04/21/2017
Last updated
04/21/2017
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