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Organization

BARDONIA PEDIATRIC ASSOC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. RONNIE KOSSOFF (BILLING MANAGER)
(845) 623-8031
Entity
Organization

Contact information

Practice address
446 ROUTE 304, BARDONIA, NY 10954-1617
(845) 623-8031
(845) 624-0928
Mailing address
446 ROUTE 304, BARDONIA, NY 10954-1617
(845) 623-8031
(845) 624-0928

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00520223
NY
Enumeration date
10/26/2006
Last updated
08/22/2020
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