Provider Demographics
NPI:1336573427
Name:GOMATHI PEDIATRICS PLLC
Entity Type:Organization
Organization Name:GOMATHI PEDIATRICS PLLC
Other - Org Name:KIDS PLUS PEDIATRICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GOMATHI
Authorized Official - Middle Name:
Authorized Official - Last Name:ADHIYAMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-634-8911
Mailing Address - Street 1:67 N MAIN ST
Mailing Address - Street 2:2 ND FLOOR
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-3700
Mailing Address - Country:US
Mailing Address - Phone:845-634-8911
Mailing Address - Fax:845-634-9002
Practice Address - Street 1:67 N MAIN ST
Practice Address - Street 2:2 ND FLOOR
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-3700
Practice Address - Country:US
Practice Address - Phone:845-634-8911
Practice Address - Fax:845-634-9002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-26
Last Update Date:2013-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY233282208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty