Provider Demographics
NPI:1033305362
Name:STEVEN PELTZ,M.D.PC
Entity type:Organization
Organization Name:STEVEN PELTZ,M.D.PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN IN CHARGE
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:PELTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-799-0608
Mailing Address - Street 1:187 VETERANS BLVD
Mailing Address - Street 2:SUITE #4
Mailing Address - City:MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-4982
Mailing Address - Country:US
Mailing Address - Phone:516-799-0608
Mailing Address - Fax:516-799-1927
Practice Address - Street 1:187 VETERANS BLVD
Practice Address - Street 2:SUITE #4
Practice Address - City:MASSAPEQUA
Practice Address - State:NY
Practice Address - Zip Code:11758-4982
Practice Address - Country:US
Practice Address - Phone:516-799-0608
Practice Address - Fax:516-799-1927
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-20
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY176064207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty