Provider Demographics
NPI:1760695399
Name:ASTORIA PEDIATRIC CENTER
Entity Type:Organization
Organization Name:ASTORIA PEDIATRIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:B
Authorized Official - Last Name:FLORIMON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-545-2500
Mailing Address - Street 1:29-22 30TH AVE.
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11102
Mailing Address - Country:US
Mailing Address - Phone:718-545-2500
Mailing Address - Fax:718-777-1369
Practice Address - Street 1:29-22 30TH AVE.
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11102
Practice Address - Country:US
Practice Address - Phone:718-545-2500
Practice Address - Fax:718-777-1369
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
=========OtherTAX ID