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Organization

PEDIATRICS 2000AT 207 STREET PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JUAN TAPIA MENDOZA MD (OWNER)
(212) 544-7777
Entity
Organization

Contact information

Practice address
515 W 207TH ST, NEW YORK, NY 10034-2645
(212) 544-7777
(212) 544-9660
Mailing address
515 W 207TH ST, NEW YORK, NY 10034-2645
(212) 544-7777
(212) 544-9660

Taxonomy

Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1194828459
NPI
NY
01
1225131592
NPI
NY
01
1326141698
NPI
NY
01
13463520408
NPI
NY
01
1346352408
NPI
NY
01
1578666061
NPI
NY
01
1760586457
NPI
NY
01
1790779064
NPI
NY
Enumeration date
03/26/2007
Last updated
02/08/2008
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