Provider Demographics
NPI:1356000160
Name:TRIBECA PEDIATRICS
Entity Type:Organization
Organization Name:TRIBECA PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:DELIA
Authorized Official - Last Name:HENRIQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-226-7666
Mailing Address - Street 1:11 PARK PL STE 1200
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10007-2823
Mailing Address - Country:US
Mailing Address - Phone:212-226-7666
Mailing Address - Fax:929-888-9562
Practice Address - Street 1:9 MCWILLIAMS PL
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07302-1609
Practice Address - Country:US
Practice Address - Phone:212-226-7666
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-09
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty