Organization
CIBAO PEDIATRICS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HECTOR ANTONIO VALENCIA M.D. (OWNER)
(212) 234-7600
Entity
Organization
Contact information
Practice address
640 W 139TH ST, NEW YORK, NY 10031-7332
(212) 234-7600
(212) 234-1796
Mailing address
3230 156TH ST, FLUSHING, NY 11354-3326
(212) 234-7600
(212) 234-1796
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02384774
—
NY
Enumeration date
01/11/2007
Last updated
08/22/2020
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