| NPI | 1275724767 |
|---|---|
| Former Legal Business Name | BOSTON ROAD PEDIATRICS, PC |
| Entity Type | Organization |
| Authorized Contact | JORGE LUIS CORNIELLE Medical Doctor 718-617-2500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 214716) |
| Enumeration Date | 2007-08-08 |
| Last Update Date | 2013-01-31 |