| NPI | 1497891139 |
|---|---|
| Other Name | PLLC |
| Entity Type | Organization |
| Authorized Contact | JODY A ROSS Owner 914-761-1717 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 156681) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 1979441) |
| 208000000X Pediatrics (Licence: NY 196252) | |
| 208000000X Pediatrics (Licence: NY 153890) | |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2020-08-22 |