Provider Demographics
NPI:1891879847
Name:PEDIATRICS 2000 III PLLC
Entity Type:Organization
Organization Name:PEDIATRICS 2000 III PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MARINO
Authorized Official - Middle Name:A
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-923-5500
Mailing Address - Street 1:135 HAVEN AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-1131
Mailing Address - Country:US
Mailing Address - Phone:212-923-5500
Mailing Address - Fax:212-795-6529
Practice Address - Street 1:135 HAVEN AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-1131
Practice Address - Country:US
Practice Address - Phone:212-923-5500
Practice Address - Fax:212-795-6529
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02047134Medicaid