Provider Demographics
NPI:1174793129
Name:PARADIGM OB/GYN SERVICES, PC
Entity type:Organization
Organization Name:PARADIGM OB/GYN SERVICES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CURTIS
Authorized Official - Middle Name:L
Authorized Official - Last Name:HARDY
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:718-592-5151
Mailing Address - Street 1:9419 60TH AVE STE D1
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-5069
Mailing Address - Country:US
Mailing Address - Phone:718-592-5151
Mailing Address - Fax:718-592-9195
Practice Address - Street 1:9419 60TH AVE STE D1
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-5069
Practice Address - Country:US
Practice Address - Phone:718-592-5151
Practice Address - Fax:718-592-9195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-05
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY217592207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02108381Medicaid
NYH31547Medicare UPIN
NY02108381Medicaid