Provider Demographics
NPI:1740825405
Name:BOBDE PEDIATRICS, PLLC
Entity type:Organization
Organization Name:BOBDE PEDIATRICS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:PATSY
Authorized Official - Last Name:BOBDE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-527-3154
Mailing Address - Street 1:970 N BROADWAY STE 303
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-1311
Mailing Address - Country:US
Mailing Address - Phone:914-966-1900
Mailing Address - Fax:914-966-0028
Practice Address - Street 1:970 N BROADWAY STE 303
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-1311
Practice Address - Country:US
Practice Address - Phone:914-966-1900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-16
Last Update Date:2019-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02238484Medicaid