I M Pediatrics Pc

LBN: I M Pediatrics Pc
I M Pediatrics Pc is an health care organization with primary practice located at 6412 Fresh Pond Rd , Ridgewood NY 11385-3331. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as the primary health care specialty. I M Pediatrics Pc can be contacted via phone (718) 497-1565, or through Mienko, Iwona Katarzyna via phone (718) 497-1565.

Contact Information

Primary practice address
6412 Fresh Pond Rd Ridgewood NY 11385-3331
Fax: (718) 497-1567
Website:
Authorized official contact:
Name: Mienko, Iwona Katarzyna Doctor of Medicine (MD)

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 217951 New York

Profile Details

NPI number 1669456984
LBN Legal business name I M Pediatrics Pc
DBA Doing business as
Authorized official Mienko, Iwona Katarzyna Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Nov 30th, 2005
Last updated Feb 24th, 2012 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669456984 NPPES
New York MEDICAID 02105622

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