Organization
PEDIATRIC SPECIALTY CONSULTATION SERVICES
Active
Organization
PEDIATRIC SPECIALTY CONSULTATION SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIELLE LARAQUE MD (CHAIRMAN, DEPARTMENT OF PEDIATRICS)
(718) 283-6150
Entity
Organization
Contact information
Practice address
4802 10TH AVE, BROOKLYN, NY 11219-2916
(718) 283-8792
Mailing address
977 48TH ST, BROOKLYN, NY 11219-2919
(718) 283-8015
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
04/07/2008
Last updated
10/19/2012
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