Provider Demographics
NPI:1053896332
Name:MANHATTAN QUEENS PEDIATRICS
Entity type:Organization
Organization Name:MANHATTAN QUEENS PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BLAIR
Authorized Official - Middle Name:J
Authorized Official - Last Name:GUIDERA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-490-2446
Mailing Address - Street 1:155 EAST 38TH STREET
Mailing Address - Street 2:SUITE 2E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016
Mailing Address - Country:US
Mailing Address - Phone:212-490-2446
Mailing Address - Fax:212-599-2376
Practice Address - Street 1:155 EAST 38TH STREET
Practice Address - Street 2:SUITE 2E
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016
Practice Address - Country:US
Practice Address - Phone:212-490-2446
Practice Address - Fax:212-599-2376
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-02
Last Update Date:2018-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty