DR. FREDRIC BOMBACK MD NPI 1417935628

NPI Information

NPI: 1417935628
Provider Name: DR. FREDRIC BOMBACK, MD
Classification: Pediatrics - 208000000X
Entity Type: Individual

PECOS Registration: Yes

Address:
99 FIELDSTONE DR
HARTSDALE, NY
ZIP 10530
Phone: (914) 428-2120
Get Directions

DR. Fredric Bomback, MD is a pediatrics in Hartsdale, NY. The provider is 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. DR. Fredric Bomback, MD NPI is 1417935628. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

99 FIELDSTONE DR
HARTSDALE, NY
ZIP 10530-564
Phone: (914) 428-2120

The NPI 1417935628 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 1/6/2006 and was last updated on 1/28/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207PP0204X	Emergency Medicine	Pediatric Emergency Medicine	106826	NEW YORK	No
2	208000000X	Pediatrics		106826	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	132625705	OTHER	NEW YORK	UNITED HEALTHCARE
2	F62445	MEDICARE UPIN	NEW YORK
3	0124825	OTHER	NEW YORK	AETNA HMO
4	712981	OTHER	NEW YORK	EMPIRE BCBS
5	WP235	OTHER	NEW YORK	OXFORD
6	1C7501	OTHER	NEW YORK	HEALTH NET
7	6301220003	OTHER	NEW YORK	CIGNA
8	712981	MEDICARE ID-TYPE UNSPECIFIED	NEW YORK
9	00187682	MEDICAID	NEW YORK
10	5238573	OTHER	NEW YORK	AETNA PPO
11	132625705	OTHER	NEW MEXICO	POMCO
12	14733	OTHER	NEW YORK	HEALTHSOURCE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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