Provider Demographics
NPI:1467446054
Name:DELMONTE PEGUERO, RAMON MARIA (MD)
Entity Type:Individual
Prefix:DR
First Name:RAMON
Middle Name:MARIA
Last Name:DELMONTE PEGUERO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:610 ACADEMY ST
Mailing Address - Street 2:SUITE 10A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10034-5058
Mailing Address - Country:US
Mailing Address - Phone:212-942-3400
Mailing Address - Fax:212-942-6031
Practice Address - Street 1:610 ACADEMY ST
Practice Address - Street 2:SUITE 10A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10034-5058
Practice Address - Country:US
Practice Address - Phone:212-942-3400
Practice Address - Fax:212-942-6031
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-09
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY184126207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01247965Medicaid
NY01247965Medicaid
F03602Medicare UPIN