Provider Demographics
NPI:1447241898
Name:ESLAMI, PEGEEN W (MD)
Entity Type:Individual
Prefix:DR
First Name:PEGEEN
Middle Name:W
Last Name:ESLAMI
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:PO BOX 415348
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-0001
Mailing Address - Country:US
Mailing Address - Phone:800-225-8885
Mailing Address - Fax:508-334-1977
Practice Address - Street 1:AOB SUITE 2400, DIVISION OF EMERGENCY MEDICINE
Practice Address - Street 2:4401 PENN AVE
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15224
Practice Address - Country:US
Practice Address - Phone:508-856-2599
Practice Address - Fax:508-856-7698
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2018-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD073706L207PP0204X, 208000000X
MA796622080P0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PP0204XAllopathic & Osteopathic PhysiciansEmergency MedicinePediatric Emergency Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3152383Medicaid
MAUX5719Medicare PIN
MA3152383Medicaid