Organization
PM PEDIATRICS OF BAYSIDE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIELLE MARIE LOPEZ (MANAGER CREDENTIALING/ENROLLMENT)
(516) 207-7936
Entity
Organization
Contact information
Practice address
19 SPRING VALLEY MARKET PLACE, SPRING VALLEY, NY 10977
(845) 371-5437
Mailing address
ONE HOLLOW LANE, SUITE 301, LAKE SUCCESS, NY 11042
(516) 869-0650
Taxonomy
Speciality
Code
Description
License number
State
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
—
—
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
Other
Enumeration date
12/12/2013
Last updated
01/21/2025
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