Provider Demographics
NPI:1205903440
Name:INTERNATIONAL PEDIATRIC HEALTH SERVICES PLLC
Entity type:Organization
Organization Name:INTERNATIONAL PEDIATRIC HEALTH SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JANE
Authorized Official - Middle Name:ELLEN
Authorized Official - Last Name:ARONSON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:212-207-6666
Mailing Address - Street 1:338 E 30TH ST
Mailing Address - Street 2:SUITE 1R
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-8318
Mailing Address - Country:US
Mailing Address - Phone:212-207-6666
Mailing Address - Fax:212-207-6665
Practice Address - Street 1:338 E 30TH ST
Practice Address - Street 2:SUITE 1R
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-8318
Practice Address - Country:US
Practice Address - Phone:212-207-6666
Practice Address - Fax:212-207-6665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY181904208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY=========OtherEMPLOYER ID NUMBER