| Dysautonomia Center Llp | |
|
530 1st Ave Suite 9q New York NY 10016-6402 | |
| (212) 263-7225 | |
| (212) 263-7041 |
| Full Name | Dysautonomia Center Llp |
|---|---|
| Speciality | Pediatrics |
| Location | 530 1st Ave, New York, New York |
| Authorized Official Name and Position | Felicia Axelrod (PARTNER) |
| Authorized Official Contact | 2122637225 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dysautonomia Center Llp 530 1st Ave Suite 9q New York NY 10016-6402 Ph: (212) 263-7225 | Dysautonomia Center Llp 530 1st Ave Suite 9q New York NY 10016-6402 Ph: (212) 263-7225 |
| NPI Number | 1568699585 |
|---|---|
| Provider Enumeration Date | 06/17/2009 |
| Last Update Date | 06/17/2009 |
| Medicare PECOS PAC ID | 4880745843 |
|---|---|
| Medicare Enrollment ID | O20090722000236 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568699585 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 168166 (New York) | Secondary |
| 208000000X | Pediatrics | 099123 (New York) | Primary |
| Provider Name | Horacio Kaufmann |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1134190291 PECOS PAC ID: 4587741020 Enrollment ID: I20080408000249 |
| Provider Name | Kaia Lee Dalamo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780248450 PECOS PAC ID: 4082040688 Enrollment ID: I20200129002970 |
| Provider Name | Alejandra Gonzalez-duarte |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1922260348 PECOS PAC ID: 6204226673 Enrollment ID: I20211130000951 |
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