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I M PEDIATRICS PC
NPI 1669456984
Pediatrics in Ridgewood, NY

Active since November 30, 2005CLIA 33D1004178 · Waiver
6412 FRESH POND RD, RIDGEWOOD, NY 11385(718) 497-1565(718) 497-1567 Get Directions Write a Review

NPPES record last updated: February 24, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About I M Pediatrics Pc NPPES

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

I M PEDIATRICS PC (NPI 1669456984) is a healthcare organization registered as a pediatrics in Ridgewood, New York and active in the NPI registry since November 2005. The organization holds a CLIA Waiver certificate valid through January 31, 2028 and lists Iwona Katarzyna Mienko, President, as its authorized official.

NPPES Registry Identity

NPI1669456984
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameI M PEDIATRICS PC
Location Address6412 FRESH POND RDRidgewood, NY 11385-3331
Mailing Address6412 Fresh Pond RdRidgewood, NY 11385-3331 · (718) 497-1565 · Fax (718) 497-1567
Phone(718) 497-1565
Fax(718) 497-1567
Organization SubpartNo
Authorized OfficialIwona Katarzyna MienkoPresident · (718) 497-1565
Enumeration DateNovember 30, 2005
Last NPPES UpdateFebruary 24, 2012
✔ NPI 1669456984 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in NY · 217951
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.
6412 FRESH POND RD, Ridgewood, NY 11385
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Other Identifiers 3

Medicare ID-Type Unspecified04341NY
Medicare UPINH30630
Medicaid02105622NY

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 33D1004178

I M Pediatrics PC · Ridgewood, NY
Active · expires Jan 31, 2028
CLIA Number33D1004178
Laboratory TypePhysician Office
Certificate Effective DateFebruary 1, 2026
Certificate Expiration DateJanuary 31, 2028
Laboratory DirectorDr. Iwona K. Mienko
Laboratory Phone(718) 497-1565
Laboratory LocationI M Pediatrics PC64-12 Fresh Pond Rd, Ridgewood, NY 11385
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

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

DR. KAREN MARIE AGLIETTI DPM
Podiatrist (Foot Surgery)
6412 FRESH POND RD
RIDGEWOOD, NY 11385
Queens County (718) 497-3000
IWONA K MIENKO MD
Pediatrics
6412 FRESH POND RD
RIDGEWOOD, NY 11385
Queens County (718) 497-1565
MIDDLE VILLAGE PODIATRY, PC
Podiatrist
6412 FRESH POND RD
RIDGEWOOD, NY 11385
Queens County (718) 497-3000

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 I M Pediatrics PC's NPI number?

The NPI number for I M Pediatrics PC is 1669456984. It was assigned to this organization in the NPPES registry on November 30, 2005.

Where is I M Pediatrics PC located?

I M Pediatrics PC is located at 6412 Fresh Pond Rd, Ridgewood, NY 11385. The listed phone number is (718) 497-1565.

What is I M Pediatrics PC's specialty?

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

Does I M Pediatrics PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D1004178) is associated with this NPI, valid through January 31, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for I M Pediatrics PC was last updated on February 24, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.