Provider Demographics
NPI:1396298402
Name:SEAFORD PEDIATRICS
Entity type:Organization
Organization Name:SEAFORD PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGENT/CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:L
Authorized Official - Last Name:MECKES
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:516-826-5900
Mailing Address - Street 1:2245 JACKSON AVE
Mailing Address - Street 2:
Mailing Address - City:SEAFORD
Mailing Address - State:NY
Mailing Address - Zip Code:11783-2646
Mailing Address - Country:US
Mailing Address - Phone:516-826-5900
Mailing Address - Fax:516-826-6039
Practice Address - Street 1:2245 JACKSON AVE
Practice Address - Street 2:
Practice Address - City:SEAFORD
Practice Address - State:NY
Practice Address - Zip Code:11783-2646
Practice Address - Country:US
Practice Address - Phone:516-826-5900
Practice Address - Fax:516-826-6039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-26
Last Update Date:2016-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY182864208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty