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NPI Code Detail

MEDICARE: DR. BRIAN GEORGE PELL M.D.

MEDICARE: DR. BRIAN GEORGE PELL 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
12084P0800XPsychiatry Physician222461NY

General Provider Information

NPI Number : 1487718185
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRIAN GEORGE PELL M.D.
Provider Business Mailing Address
First Line : 385 5TH AVE RM 1106
Second Line :
City : NEW YORK
State : NY
Zip : 10016-3340
Country : US
Telephone Number : 917-391-0076
Fax Number :
Provider Business Practice Location Address
First Line : 385 5TH AVE RM 1106
Second Line :
City : NEW YORK
State : NY
Zip : 10016-3340
Country : US
Telephone Number : 917-391-0076
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/20/2006
Last Update Date : 07/14/2022

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