Provider Demographics
NPI:1093716987
Name:PELUSO, RALPH B (MD)
Entity Type:Individual
Prefix:DR
First Name:RALPH
Middle Name:B
Last Name:PELUSO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8210 18TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-2901
Mailing Address - Country:US
Mailing Address - Phone:718-331-6600
Mailing Address - Fax:718-259-0094
Practice Address - Street 1:8210 18TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-2901
Practice Address - Country:US
Practice Address - Phone:718-331-6600
Practice Address - Fax:718-259-0094
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY170592207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine