Provider Demographics
NPI:1184783938
Name:NORTH ROCKLAND PEDIATRIC ASSOCIOATES,P.C.
Entity type:Organization
Organization Name:NORTH ROCKLAND PEDIATRIC ASSOCIOATES,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:LAUB
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-947-1772
Mailing Address - Street 1:171 RAMAPO RD
Mailing Address - Street 2:
Mailing Address - City:GARNERVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10923-1552
Mailing Address - Country:US
Mailing Address - Phone:845-947-1772
Mailing Address - Fax:845-947-4487
Practice Address - Street 1:171 RAMAPO RD
Practice Address - Street 2:
Practice Address - City:GARNERVILLE
Practice Address - State:NY
Practice Address - Zip Code:10923-1552
Practice Address - Country:US
Practice Address - Phone:845-947-1772
Practice Address - Fax:845-947-4487
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-07
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
NY00418979Medicaid