WYCKOFF PEDIATRIC CARE CENTER
NPI 1972926814
Pediatrics in Brooklyn, NY

Active since January 29, 2014CLIA 33D2054035 · Waiver
1411 MYRTLE AVE, 1411 MYRTLE AVENUE, BROOKLYN, NY 11237(718) 907-4301(718) 919-1309 Get Directions Write a Review

NPPES record last updated: April 2, 2019. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Wyckoff Pediatric Care Center NPPES

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

WYCKOFF PEDIATRIC CARE CENTER (NPI 1972926814) is a healthcare organization registered as a pediatrics in Brooklyn, New York and active in the NPI registry since January 2014. The organization holds a CLIA Waiver certificate valid through March 26, 2027 and lists Vali Gache, Chief Financial Officer, as its authorized official.

NPPES Registry Identity

NPI1972926814
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameWYCKOFF PEDIATRIC CARE CENTER
Location Address1411 MYRTLE AVE, 1411 MYRTLE AVENUEBrooklyn, NY 11237-4512
Mailing Address1411 Myrtle Ave, Wyckoff Pediatric Care CenterBrooklyn, NY 11237-4512 · (718) 907-4301 · Fax (718) 919-1309
Fax(718) 919-1309
Organization SubpartYesParent: Wyckoff Professional Medical Services Pc
Authorized OfficialVali GacheChief Financial Officer · (718) 240-1795
Enumeration DateJanuary 29, 2014
Last NPPES UpdateApril 2, 2019
NPI 1972926814 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
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.

1411 MYRTLE AVE, Brooklyn, NY 11237

Other Identifiers 1

Medicaid03722025NY

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-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 33D2054035

Wyckoff Pediatric Center · Brooklyn, NY
Active · expires Mar 26, 2027
CLIA Number33D2054035
Laboratory TypeCommunity Clinic
Certificate Effective DateAugust 26, 2015
Certificate Expiration DateMarch 26, 2027
Laboratory DirectorDr. Wilhelmina P. Cruz-Vetrano
Laboratory Phone(718) 907-4301
Laboratory LocationWyckoff Pediatric Center1411 Myrtle Ave, Brooklyn, NY 11237
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

Pediatrics
1411 MYRTLE AVE
BROOKLYN, NY 11237

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1972926814, enumerated as an "organization" on January 29, 2014.

The provider is located at 1411 MYRTLE AVE 1411 MYRTLE AVENUE BROOKLYN, NY 11237 and the phone number is (718) 907-4301.

Pediatrics with taxonomy code 208000000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.