Provider Demographics
NPI:1487867727
Name:HAMBURG PEDIATRICS, P.C.
Entity Type:Organization
Organization Name:HAMBURG PEDIATRICS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:KRZAN
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:716-312-7400
Mailing Address - Street 1:4390 QUINBY DR STE E
Mailing Address - Street 2:
Mailing Address - City:HAMBURG
Mailing Address - State:NY
Mailing Address - Zip Code:14075-7900
Mailing Address - Country:US
Mailing Address - Phone:716-312-7400
Mailing Address - Fax:716-312-7402
Practice Address - Street 1:4390 QUINBY DR STE E
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:NY
Practice Address - Zip Code:14075-7900
Practice Address - Country:US
Practice Address - Phone:716-312-7400
Practice Address - Fax:716-312-7402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1714872080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY061226000052OtherFIDELIS
NY00010096202OtherUNIVERA
NY000527622002OtherBLUE CROSS BLUE SHIELD
NY1202710OtherIHA
NY01136070Medicaid