Provider Demographics
NPI:1750685798
Name:FORT WASHINGTON PEDIATRICS, PC
Entity type:Organization
Organization Name:FORT WASHINGTON PEDIATRICS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FRANKLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SENCION
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-927-0013
Mailing Address - Street 1:65 FORT WASHINGTON AVE
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-4634
Mailing Address - Country:US
Mailing Address - Phone:212-927-0013
Mailing Address - Fax:212-927-0014
Practice Address - Street 1:65 FORT WASHINGTON AVE
Practice Address - Street 2:SUITE 1B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-4634
Practice Address - Country:US
Practice Address - Phone:212-927-0013
Practice Address - Fax:212-927-0014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-05
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY232414208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY=========OtherTAX ID