Provider Demographics
NPI:1043391477
Name:PECK, ROCHELLE L (MD)
Entity Type:Individual
Prefix:
First Name:ROCHELLE
Middle Name:L
Last Name:PECK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 WEST 72ND ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-6917
Mailing Address - Country:US
Mailing Address - Phone:212-496-5870
Mailing Address - Fax:
Practice Address - Street 1:40 WEST 72ND ST
Practice Address - Street 2:SUITE A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-6917
Practice Address - Country:US
Practice Address - Phone:212-496-5870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2010-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY153620207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology