Provider Demographics
NPI:1144455577
Name:PRIORITY PEDIATRICS, PLLC
Entity type:Organization
Organization Name:PRIORITY PEDIATRICS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:H
Authorized Official - Last Name:VAN AMERANGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-599-5437
Mailing Address - Street 1:444 MERRICK RD.
Mailing Address - Street 2:SUITE LL2
Mailing Address - City:LYNBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11563-2456
Mailing Address - Country:US
Mailing Address - Phone:516-599-5437
Mailing Address - Fax:
Practice Address - Street 1:444 MERRICK RD.
Practice Address - Street 2:SUITE LL2
Practice Address - City:LYNBROOK
Practice Address - State:NY
Practice Address - Zip Code:11563-2456
Practice Address - Country:US
Practice Address - Phone:516-599-5437
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-29
Last Update Date:2009-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174703-1208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty