Provider Demographics
NPI:1366835266
Name:RYE PEDIATRICS
Entity Type:Organization
Organization Name:RYE PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELENA
Authorized Official - Middle Name:ERIKA
Authorized Official - Last Name:GAZZOLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-967-9000
Mailing Address - Street 1:150 PURCHASE ST
Mailing Address - Street 2:SUITE 8A
Mailing Address - City:RYE
Mailing Address - State:NY
Mailing Address - Zip Code:10580-2141
Mailing Address - Country:US
Mailing Address - Phone:914-967-9000
Mailing Address - Fax:914-967-9003
Practice Address - Street 1:150 PURCHASE ST
Practice Address - Street 2:SUITE 8A
Practice Address - City:RYE
Practice Address - State:NY
Practice Address - Zip Code:10580-2141
Practice Address - Country:US
Practice Address - Phone:914-967-9000
Practice Address - Fax:914-967-9003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-17
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY215407261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care