Provider Demographics
NPI:1154585347
Name:ADIPEDIATRICS
Entity type:Organization
Organization Name:ADIPEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VIJAY
Authorized Official - Middle Name:KUMAR
Authorized Official - Last Name:ADI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-627-0627
Mailing Address - Street 1:124 COMANCHE TRL
Mailing Address - Street 2:
Mailing Address - City:NISKAYUNA
Mailing Address - State:NY
Mailing Address - Zip Code:12309-2243
Mailing Address - Country:US
Mailing Address - Phone:518-627-0627
Mailing Address - Fax:518-627-0628
Practice Address - Street 1:2614 RIVERFRONT CTR
Practice Address - Street 2:
Practice Address - City:AMSTERDAM
Practice Address - State:NY
Practice Address - Zip Code:12010-4615
Practice Address - Country:US
Practice Address - Phone:518-627-0627
Practice Address - Fax:518-627-0628
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-16
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY223735208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty