Provider Demographics
NPI:1952652943
Name:PEDIATRIC GROUP OF NEW ROCHELLE PC
Entity Type:Organization
Organization Name:PEDIATRIC GROUP OF NEW ROCHELLE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:J
Authorized Official - Last Name:MEYERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-235-3800
Mailing Address - Street 1:140 LOCKWOOD AVENUE
Mailing Address - Street 2:SUITE 115
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801
Mailing Address - Country:US
Mailing Address - Phone:914-235-3800
Mailing Address - Fax:914-235-8185
Practice Address - Street 1:140 LOCKWOOD AVENUE
Practice Address - Street 2:SUITE 115
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801
Practice Address - Country:US
Practice Address - Phone:914-235-3800
Practice Address - Fax:914-235-8185
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-01
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty