Provider Demographics
NPI:1912605759
Name:TRIBORO PEDIATRICS MEDICAL PC
Entity Type:Organization
Organization Name:TRIBORO PEDIATRICS MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TOMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:GALANIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-507-5800
Mailing Address - Street 1:3540 82ND ST STE 1D
Mailing Address - Street 2:
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-5106
Mailing Address - Country:US
Mailing Address - Phone:718-507-5800
Mailing Address - Fax:718-507-2154
Practice Address - Street 1:3540 82ND ST STE 1D
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-5106
Practice Address - Country:US
Practice Address - Phone:718-507-5800
Practice Address - Fax:718-507-2154
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-21
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty