Dr. Fredric Bomback
Pediatrician Pediatric Emergency Physician
99 Fieldstone Dr
Hartsdale
, New York 10530-1564
Dr. Fredric Bomback
Pediatrician Pediatric Emergency Physician
99 Fieldstone Dr
Hartsdale
, New York 10530-1564
(914) 428-2120
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About
Features
Specialties
- Pediatric Emergency Physician
- Pediatrician
Languages spoken
- English
Location
First Address
- Dr. Fredric Bomback
- 99 Fieldstone Dr
- Hartsdale, NY
- Zip : 10530-1564
- Phone : (914) 428-2120
Second Address
- Dr. Fredric Bomback
- 99 Fieldstone Dr
- Hartsdale, NY
- Zip : 10530-1564
- Phone : (914) 428-2120
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207PP0204X | Pediatric Emergency Physician | 106826 | NY |
| Y | 208000000X | Pediatrician | 106826 | NY |
National Provider Identifier
| NPI | 1417935628 |
|---|---|
| Provider Name | Dr. Fredric Bomback |
| First Address | Hartsdale, NY 10530-1564 |
| Second Address | Hartsdale, NY 10530-1564 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 06/01/2006 |
| Last Update Date | 28/01/2014 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 00187682 | (05) | NY |
| 0124825 | AETNA HMO (01) | NY |
| 132625705 | POMCO (01) | NM |
| 132625705 | UNITED HEALTHCARE (01) | NY |
| 14733 | HEALTHSOURCE (01) | NY |
| 1C7501 | HEALTH NET (01) | NY |
| 5238573 | AETNA PPO (01) | NY |
| 6301220003 | CIGNA (01) | NY |
| 712981 | EMPIRE BCBS (01) | NY |
| F62445 | (02) | NY |
| WP235 | OXFORD (01) | NY |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.