Provider Demographics
NPI:1952619686
Name:PEKARSKY, DMITRY PEKARSKY (MD)
Entity Type:Individual
Prefix:MR
First Name:DMITRY PEKARSKY
Middle Name:
Last Name:PEKARSKY
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 1:97-28 63RD ROAD
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374
Mailing Address - Country:US
Mailing Address - Phone:347-730-4606
Mailing Address - Fax:888-500-0406
Practice Address - Street 1:97-28 63RD ROAD
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374
Practice Address - Country:US
Practice Address - Phone:347-730-4606
Practice Address - Fax:888-500-0406
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-15
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY291899-012085R0202X
PAMT1956222085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology