LAKE GROVE PEDIATRICS, PC
NPI 1447543913
Pediatrics in Lake Grove, NY

Q: What is Lake Grove Pediatrics, PC's NPI number?

The NPI number for Lake Grove Pediatrics, PC is 1447543913. It was assigned to this organization in the NPPES registry on May 17, 2011.

Q: What is Lake Grove Pediatrics, PC's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Active since May 17, 2011CLIA 33D2027000 · Waiver

2233 NESCONSET HWY, SUITE 106, LAKE GROVE, NY 11755(631) 585-4440 Get Directions Write a Review

NPPES record last updated: May 17, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Lake Grove Pediatrics, Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LAKE GROVE PEDIATRICS, PC (NPI 1447543913) is a healthcare organization registered as a pediatrics in Lake Grove, New York and active in the NPI registry since May 2011. The organization holds a CLIA Waiver certificate valid through July 13, 2027 and lists Amy Dawn Goldberg, Owner, as its authorized official.

NPPES Registry Identity

NPI1447543913

Entity TypeOrganization

Primary Taxonomy208000000X

Legal Business NameLAKE GROVE PEDIATRICS, PC

Location Address2233 NESCONSET HWY, SUITE 106Lake Grove, NY 11755-1000

Mailing Address2233 Nesconset Hwy, Suite 106Lake Grove, NY 11755-1000 · (631) 585-4440

Phone(631) 585-4440

Organization SubpartNo

Authorized OfficialAmy Dawn GoldbergOwner · 63158544400

Enumeration DateMay 17, 2011

✔ NPI 1447543913 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

License✔ Licensed in NY · 225178

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

2233 NESCONSET HWY, Lake Grove, NY 11755

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 33D2027000

Lake Grove Pediatrics, PC · Lake Grove, NY

Active · expires Jul 13, 2027

CLIA Number33D2027000

Laboratory TypePhysician Office

Certificate Effective DateJuly 14, 2025

Certificate Expiration DateJuly 13, 2027

Laboratory DirectorDr. Amy D. Goldberg

Laboratory Phone(631) 585-4440

Laboratory LocationLake Grove Pediatrics, PC2233 Nesconset Hwy, Suite 207, Lake Grove, NY 11755

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EAST COAST FERTILITY, P.C.

Obstetrics & Gynecology (Reproductive Endocrinology)

2233 NESCONSET HWY, SUITE 107
LAKE GROVE, NY 11755

Suffolk County (516) 939-2229

TONI ANN E MULE MHC-LP

Counselor (Mental Health)

2233 NESCONSET HWY
LAKE GROVE, NY 11755

Suffolk County (631) 560-0994

DR. CLIFFORD A. DUKOFSKY D.C.

Chiropractor

2233 NESCONSET HWY, SUITE 102
LAKE GROVE, NY 11755

Suffolk County (631) 698-9800

DR. EDWARD M BRAM D.M.D.

Dentist (General Practice)

2233 NESCONSET HWY, SUITE 101
LAKE GROVE, NY 11755

Suffolk County (631) 588-3636

SMITH HAVEN DENTISTRY, PLLC

Clinic/Center (Dental)

2233 NESCONSET HWY, STE #101
LAKE GROVE, NY 11755

Suffolk County (631) 588-3636

ANDREW HERBST LMHC

Counselor (Mental Health)

2233 NESCONSET HWY
LAKE GROVE, NY 11755

Suffolk County (631) 521-9603

DR. JOHN TSOURIS D.P.M.

Podiatrist (Foot Surgery)

2233 NESCONSET HWY, SUITE 206
LAKE GROVE, NY 11755

Suffolk County (631) 751-4603

MS. JENNIFER FAZIO LMSW

Social Worker (Clinical)

2233 NESCONSET HWY, SUITE 104
LAKE GROVE, NY 11755

Suffolk County (631) 737-5559

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lake Grove Pediatrics, PC's NPI number?

The NPI number for Lake Grove Pediatrics, PC is 1447543913. It was assigned to this organization in the NPPES registry on May 17, 2011.

Where is Lake Grove Pediatrics, PC located?

Lake Grove Pediatrics, PC is located at 2233 Nesconset Hwy Suite 106, Lake Grove, NY 11755. The listed phone number is (631) 585-4440.

What is Lake Grove Pediatrics, PC's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Does Lake Grove Pediatrics, PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D2027000) is associated with this NPI, valid through July 13, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Lake Grove Pediatrics, PC was last updated on May 17, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.