Provider Demographics
NPI:1255596391
Name:HJD PEDIATRICS GROUP
Entity type:Organization
Organization Name:HJD PEDIATRICS GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LOIS
Authorized Official - Middle Name:S
Authorized Official - Last Name:HALBER
Authorized Official - Suffix:
Authorized Official - Credentials:RHIA
Authorized Official - Phone:212-460-0110
Mailing Address - Street 1:380 2ND AVE
Mailing Address - Street 2:ROOM 636
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-5615
Mailing Address - Country:US
Mailing Address - Phone:212-460-0110
Mailing Address - Fax:212-460-0160
Practice Address - Street 1:301 E 17TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-3804
Practice Address - Country:US
Practice Address - Phone:212-460-0110
Practice Address - Fax:212-460-0160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-28
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty