Provider Demographics
NPI:1316034523
Name:PETER B DEKAY MD LLC
Entity Type:Organization
Organization Name:PETER B DEKAY MD LLC
Other - Org Name:ALPINE WOMENS HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:BENJAMIN
Authorized Official - Last Name:DEKAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:775-827-0777
Mailing Address - Street 1:645 N ARLINGTON AVE
Mailing Address - Street 2:STE 340
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89503-4505
Mailing Address - Country:US
Mailing Address - Phone:775-827-0777
Mailing Address - Fax:775-322-5744
Practice Address - Street 1:645 N ARLINGTON AVE
Practice Address - Street 2:STE 340
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89503-4505
Practice Address - Country:US
Practice Address - Phone:775-827-0777
Practice Address - Fax:775-322-5744
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-07
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
V40216Medicare ID - Type Unspecified