VILLAGE PEDIATRIC GROUP PLLC (NPI# 1861626210) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861626210 |
| Entity Type | Organization |
| Organization Name | VILLAGE PEDIATRIC GROUP PLLC |
| Other Organization Name | VILLAGE PEDIATRIC GROUP PLLC |
| Practice Address |
115 Main St Suite 301 Tuckahoe NY 10707-2911 |
| Practice Telephone | 9147717070 |
| Practice Fax Number | 9147717073 |
| Mailing Telephone | 9147717070 |
| Mailing Fax Number | 9147717073 |
| Enumeration Date | 2009-05-13 |
| Last Update Date | 2009-05-13 |
| Authorized Official Name | MRS. KAIRA RIVERA (BILLING MANAGER) |
| Authorized Official Telephone | 9147717070 |
| Is Organization Subpart | Y |
| Parent Organization Name | VILLAGE PEDIATRIC GROUP PLLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | 225800 | NY | Allopathic & Osteopathic Physicians |
| Y | 208000000X | Pediatrics | 216946 | NY | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Village Pediatric Group PLLC | Former Legal Business Name - Organization |
| Street Address |
115 MAIN ST SUITE 301 |
| City | TUCKAHOE |
| State | NY |
| Zip Code | 10707-2911 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760755961 | O & P Plus | Pedorthist | 115 Main St, Suite 202, Tuckahoe, NY 10707-2948 | 2012-02-17 |
| 1932484508 | Axiom Pt & Ot Plus Pllc | Pedorthist | 115 Main St, Suite: # 202, Tuckahoe, NY 10707-2911 | 2011-10-14 |
| 1588960652 | Advanced Audiology of Ny PC | Audiologist-Hearing Aid Fitter | 115 Main St, Tuckahoe, NY 10707-2911 | 2011-02-07 |
| 1275851552 | Axiom Pt & Ot Plus | Occupational Therapist | 115 Main St, Suite 202, Tuckahoe, NY 10707-2911 | 2010-05-11 |
| 1821229469 | Glen Joseph Santacroce | Occupational Therapist | 115 Main St, Suite 202 2nd Floor, Tuckahoe, NY 10707-2948 | 2009-07-30 |
| 1417185018 | Vita M Dequatro | Physical Therapist | 115 Main St, Suite#202 2nd Floor, Tuckahoe, NY 10707-2948 | 2009-06-23 |
| 1316173289 | Anate Brauer | Obstetrics & Gynecology | 115 Main St, Tuckahoe, NY 10707-2948 | 2009-06-05 |
| 1417102047 | Aida I Colon | Occupational Therapist | 115 Main St, Axiom Pt & Ot Plus, Pllc-suite 202, Tuckahoe, NY 10707-2948 | 2008-11-24 |
| 1467609990 | Jasen Albert Ruiz | Audiologist-Hearing Aid Fitter | 115 Main St, Suite A, Tuckahoe, NY 10707-2948 | 2008-08-27 |
| 1255532636 | Randy Lunenfeld | Dentist | 115 Main St, 1b, Tuckahoe, NY 10707-2948 | 2007-05-31 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932729761 | Mariana Gutierrez | Registered Nurse | 1 Park Avenue Apt #j1, Tuckahoe, NY 10707 | 2020-04-22 |
| 1063774495 | Kristy B Breckenridge Schurr | Early Intervention Provider Agency | 7 Oak Avenue, 2, Tuckahoe, NY 10707 | 2012-06-12 |
| 1669797650 | Meghan Elizabeth Mcauley | Speech-Language Pathologist | 22 Underhill Street, Tuckahoe, NY 10707 | 2010-04-01 |
| 1215187489 | Thomas Aquinas Fischer | Psychologist | 111 Lake Avenue Suite 4, Tuckahoe, NY 10707 | 2008-09-24 |
| 1285829978 | Kartika Khanna | Pediatrics | 107 W Fourth St, Mt Vernon Neighborhood Health Centre,inc, Mt Vernon, NY 10707 | 2007-09-06 |
| 1891917886 | Clifford Joseph Cozolino | Chiropractor | 335 Columbus Ave., Tuckahoe, NY 10707 | 2007-05-02 |
| 1174683742 | Ellen Donna Teplitz | Dermatology | 1 Elm Street Parkway Plaza Medical Center, Suite 2b, Tuckahoe, NY 10707 | 2006-12-12 |
| 1427023209 | Jayne Fanta Betts | Nurse Practitioner | 375 White Plains Rd., Minute Clinic of New York Inside Cvs Pharmacy, Eastchester, NY 10707 | 2006-02-23 |
| 1033679592 | Alejandro Diaz | Counselor | 68 Main St, Suite 340, Tuckahoe, NY 10707 | 2019-03-21 |
| 1306200191 | Susan Scharf | Social Worker | 65 Main Street, Andrus Early Learning Center, Tuckahoe, NY 10707 | 2016-04-08 |
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| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093748014 | Jessica Sessions | Pediatrics | 115 Main St Ste 301, Tuckahoe, NY 10707-2949 | 2006-07-10 |
| 1639170905 | Kerry A Purtill | Pediatrics | 1 Elm St, Tuckahoe, NY 10707-3925 | 2005-08-09 |
| 1437390952 | Childrens Medical Practice of Bronxville | Pediatrics | 1 Elm St, Suite 1b, Tuckahoe, NY 10707-3925 | 2009-03-12 |
| 1528191137 | Manju Malhotra | Pediatrics | 1 Elm St, Tuckahoe, NY 10707-3925 | 2007-03-13 |
| 1710049622 | Florencia Karin Braier | Pediatrics | 115 Main Street, Suite 301, Tuckahoe, NY 10707-2911 | 2006-12-15 |
| 1639245244 | Heather A. Mcgowan | Pediatrics | 115 Main Street, Suite 301, Tuckahoe, NY 10707-2911 | 2006-11-27 |
| 1730278433 | Marc J Rabuse | Pediatrics | 1 Elm St, Suite 1b, Tuckahoe, NY 10707-3925 | 2006-10-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518577550 | Danielle Vann | Pediatrics | 151 N Washington St # 2s, Sleepy Hollow, NY 10591-3117 | 2020-08-04 |
| 1699392357 | Long Island Pediatrics of Patchogue PC | Pediatrics | 475 E Main St Ste 109, Patchogue, NY 11772-3121 | 2020-06-29 |
| 1811510811 | Dr Pediatric PC | Pediatrics | 38 Hopewell Dr, Stony Brook, NY 11790-2339 | 2020-05-26 |
| 1598386864 | Sandra Howard Bonat | Pediatrics | 4 Filomena Ct, Dix Hills, NY 11746-4750 | 2020-04-28 |
| 1497374359 | Medical Health 360 Pllc | Pediatrics | 16955 County Route 59, Dexter, NY 13634-2027 | 2020-04-10 |
| 1922633007 | Danzi & Hajduk-bennett Pediatrics Pllc | Pediatrics | 994 W Jericho Tpke Ste 202, Smithtown, NY 11787-3234 | 2020-03-09 |
| 1396377180 | Chelsea Oberkrieser | Pediatrics | 17 Long Ave Ste 110, Hamburg, NY 14075-6200 | 2020-02-10 |
| 1619508900 | Total Care Pediatrics Pllc | Pediatrics | 4265 Kissena Blvd # L4, Flushing, NY 11355-3273 | 2020-01-27 |
| 1639709157 | Decerina Uy Md PC | Pediatrics | 649 Route 25a Ste 3, Rocky Point, NY 11778-8983 | 2020-01-23 |
| 1447890603 | Opear Holdings, Inc | Pediatrics | 2635 Frances St, Bellmore, NY 11710-5401 | 2020-01-15 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.