Organization
WYCKOFF PEDIATRIC CARE CENTER
Active
Parent organization
WYCKOFF PROFESSIONAL MEDICAL SERVICES PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
WYCKOFF PROFESSIONAL MEDICAL SERVICES PC
Authorized official
MR. FRANK VUTRANO (CHIEF FINANCIAL OFFICER)
(718) 963-6702
Entity
Organization
Contact information
Practice address
374 STOCKHOLM STREET, WYCKOFF HEIGHTS MEDICAL CENTER - FACULTY PRACTICE, BROOKLYN, NY 11237
(718) 963-7272
Mailing address
1411 MYRTLE AVENUE, WYCKOFF PEDIATRIC CARE CENTER, BROOKLYN, NY 11237
(718) 907-4301
(718) 919-1309
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03722025
—
NY
Enumeration date
05/28/2015
Last updated
05/28/2015
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