Provider Demographics
NPI:1205482452
Name:MANHATTAN VALLEY PEDIATRICS
Entity type:Organization
Organization Name:MANHATTAN VALLEY PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:HELAINE
Authorized Official - Last Name:HOFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-575-0133
Mailing Address - Street 1:1855 ADAM CLAYTON POWELL JR BLVD APT 6A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10026-2818
Mailing Address - Country:US
Mailing Address - Phone:917-575-0133
Mailing Address - Fax:
Practice Address - Street 1:2637 BROADWAY
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-5022
Practice Address - Country:US
Practice Address - Phone:917-575-0133
Practice Address - Fax:347-274-3095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-14
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty