Provider Demographics
NPI:1629038500
Name:WOO, PEAK (MD)
Entity Type:Individual
Prefix:
First Name:PEAK
Middle Name:
Last Name:WOO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 CENTRAL PARK W APT 1H
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-1590
Mailing Address - Country:US
Mailing Address - Phone:212-580-1004
Mailing Address - Fax:212-580-6101
Practice Address - Street 1:300 CENTRAL PARK WEST 1H
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024
Practice Address - Country:US
Practice Address - Phone:212-580-1004
Practice Address - Fax:212-580-6101
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-24
Last Update Date:2011-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY153907207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00775062Medicaid
NY00775062Medicaid
B81450Medicare UPIN