Provider Demographics
NPI:1770683146
Name:BSM PEDIATRICS PC
Entity Type:Organization
Organization Name:BSM PEDIATRICS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:GERARD
Authorized Official - Last Name:MONTI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-722-0707
Mailing Address - Street 1:55 E 87TH ST
Mailing Address - Street 2:SUITE 1G
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-1049
Mailing Address - Country:US
Mailing Address - Phone:212-722-0707
Mailing Address - Fax:212-987-1949
Practice Address - Street 1:55 E 87TH ST
Practice Address - Street 2:SUITE 1G
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-1049
Practice Address - Country:US
Practice Address - Phone:212-722-0707
Practice Address - Fax:212-987-1949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY=========OtherUNITED HEALTHCARE