Provider Demographics
NPI:1073227245
Name:EXPRESS PEDIATRICS
Entity Type:Organization
Organization Name:EXPRESS PEDIATRICS
Other - Org Name:PREMIER PEDIATRICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REUVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BLOBSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-712-6006
Mailing Address - Street 1:26 FIREMENS MEMORIAL DR STE 120
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:NY
Mailing Address - Zip Code:10970-3576
Mailing Address - Country:US
Mailing Address - Phone:845-712-6006
Mailing Address - Fax:845-714-0994
Practice Address - Street 1:26 FIREMENS MEMORIAL DR STE 120
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:NY
Practice Address - Zip Code:10970-3576
Practice Address - Country:US
Practice Address - Phone:845-712-6006
Practice Address - Fax:845-714-0994
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EXPRESS PEDIATRICS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-01-11
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty