Southern Tier Pediatrics Practice, P.c.
Pediatric Adolescent Medicine
Southern Tier Pediatrics Practice, P.c. is a Jamestown, New York based Pediatric center with medical specialization in
Pediatric Adolescent Medicine.
It is located at
1684 Foote Avenue Ext, Jamestown, New York - 14701-9385. They can be contacted on phone at
716-661-9730 and fax number 716-661-9732.
NPI number (Unique professional ID) for Southern Tier Pediatrics Practice, P.c. is
1710902200 which was assigned by NPPES on 13 Jul, 2006 and it was last updated on 15 May, 2013.
Southern Tier Pediatrics Practice, P.c. license number is
207469 for Pediatrics Adolescent Medicine (2080A0000X) in New York.
Southern Tier Pediatrics Practice, P.c. specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
Complete Profile:
Southern Tier Pediatrics Practice, P.c. basic information including their official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics Adolescent Medicine |
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| Provider Name : | Southern Tier Pediatrics Practice, P.c. |
|---|
Business Address:
Southern Tier Pediatrics Practice, P.c. address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 1684 Foote Avenue Ext
Jamestown, NY, 14701-9385
United States |
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| Phone Number : | 716-661-9730 |
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| Fax Number : | 716-661-9732 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1710902200 |
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| NPI Entity Type : | Organization |
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| First Enrolment Date : | 13 Jul, 2006 |
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| Last Updated On : | 15 May, 2013 |
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Authorized Official Details:
Officially authorized person to contact for any management issues or complaints of this organization are as below. Person's position and contact details are as mentioned below.
| Authorized Official Name : | Tariqm Khan |
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| Authorized Official Credential : | M.D. |
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| Official Title or Position : | PRESIDENT |
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| Phone Number : | 716-661-9730 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Southern Tier Pediatrics Practice, P.c. are as mentioned. Primary taxonomy code for Southern Tier Pediatrics Practice, P.c. is
2080A0000X (Pediatrics Adolescent Medicine).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 2080A0000X | Pediatrics Adolescent Medicine | Yes | 207469 | NY |
Legacy Identifiers:
Other legacy medical identifiers of Southern Tier Pediatrics Practice, P.c. such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| ========= | Other | NY | FEDERAL TAX ID |
| 01664951 | MEDICAID | NY | |
| 02690682 | MEDICAID | NY | |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 1684 Foote Avenue Ext
Jamestown, NY, 14701-9385
United States |
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| Phone Number : | 716-661-9730 |
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| Fax Number : | 716-661-9732 |
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Business Location:
Patients can refer following map for directions to
Southern Tier Pediatrics Practice, P.c. practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 January, 2024.