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NPI Code Detail

MEDICARE: STEVEN PELAEZ M.D.

MEDICARE: STEVEN PELAEZ M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208600000XSurgery Physician170044-1NY
2208C00000XColon & Rectal Surgery Physician170044-1NY

General Provider Information

NPI Number : 1083638118
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEVEN PELAEZ M.D.
Provider Business Mailing Address
First Line : 1100 FRANKLIN AVE
Second Line : SUITE 203
City : GARDEN CITY
State : NY
Zip : 11530-3221
Country : US
Telephone Number : 516-248-2422
Fax Number : 516-248-5162
Provider Business Practice Location Address
First Line : 1100 FRANKLIN AVE
Second Line : SUITE 203
City : GARDEN CITY
State : NY
Zip : 11530-3221
Country : US
Telephone Number : 516-248-2422
Fax Number : 516-248-5162
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2006
Last Update Date : 08/28/2014

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