Provider Demographics
NPI:1568628154
Name:MADISON PEDIATRICS P.C.
Entity Type:Organization
Organization Name:MADISON PEDIATRICS P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:EVERTON
Authorized Official - Last Name:HUTCHINSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-410-5700
Mailing Address - Street 1:221 W. 138TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10030-2102
Mailing Address - Country:US
Mailing Address - Phone:212-368-1100
Mailing Address - Fax:212-368-1103
Practice Address - Street 1:221 W. 138TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10030-2102
Practice Address - Country:US
Practice Address - Phone:212-368-1100
Practice Address - Fax:212-368-1103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-02
Last Update Date:2009-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY128966261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty