Provider Demographics
NPI:1144489188
Name:CENTRAL AVENUE PEDIATRICS
Entity type:Organization
Organization Name:CENTRAL AVENUE PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHIFFER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-472-4300
Mailing Address - Street 1:1075 CENTRAL PARK AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-3242
Mailing Address - Country:US
Mailing Address - Phone:914-472-4300
Mailing Address - Fax:914-472-2489
Practice Address - Street 1:1075 CENTRAL PARK AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-3242
Practice Address - Country:US
Practice Address - Phone:914-472-4300
Practice Address - Fax:914-472-2489
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-05
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty