Provider Demographics
NPI:1750037412
Name:EMMETT PEDIATRIC ASSOCIATES
Entity Type:Organization
Organization Name:EMMETT PEDIATRIC ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:EMMETT
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:516-312-2009
Mailing Address - Street 1:3104 QUENTIN RD
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-4200
Mailing Address - Country:US
Mailing Address - Phone:718-338-5544
Mailing Address - Fax:
Practice Address - Street 1:3104 QUENTIN RD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-4200
Practice Address - Country:US
Practice Address - Phone:718-338-5544
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-22
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty