Provider Demographics
NPI:1710057872
Name:CAMKIDS PEDIATRICS PC
Entity Type:Organization
Organization Name:CAMKIDS PEDIATRICS PC
Other - Org Name:MARIE-PAULE DUPITON MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PEDIATRICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIE-PAULE
Authorized Official - Middle Name:J
Authorized Official - Last Name:DUPITON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-712-8511
Mailing Address - Street 1:11706 225TH ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIA HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11411-1706
Mailing Address - Country:US
Mailing Address - Phone:718-712-8511
Mailing Address - Fax:718-527-5624
Practice Address - Street 1:11706 225TH STREET
Practice Address - Street 2:
Practice Address - City:CAMBRIA HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11411
Practice Address - Country:US
Practice Address - Phone:718-712-8511
Practice Address - Fax:718-527-5624
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY211104208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01922325Medicaid
NY01922325Medicaid