Provider Demographics
NPI:1750643441
Name:DELIZ, PETER
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:
Last Name:DELIZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 WESKORA RD
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:10598-2125
Mailing Address - Country:US
Mailing Address - Phone:914-962-7798
Mailing Address - Fax:
Practice Address - Street 1:155 WESKORA RD
Practice Address - Street 2:
Practice Address - City:YORKTOWN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:10598-2125
Practice Address - Country:US
Practice Address - Phone:914-962-7798
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-09
Last Update Date:2012-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist