MEDICARE: PETER GREKIN 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
1	207PE0004X	Emergency Medical Services (Emergency Medicine) Physician	216692	NY

General Provider Information

NPI Number	:	1821081506
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PETER GREKIN M.D.

Provider Business Mailing Address
First Line	:	84 CHAPEL RD
Second Line	:
City	:	WACCABUC
State	:	NY
Zip	:	10597-1008
Country	:	US
Telephone Number	:	914-533-2423
Fax Number	:

Provider Business Practice Location Address
First Line	:	423 E 23RD ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10010-5011
Country	:	US
Telephone Number	:	212-686-7500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/26/2005
Last Update Date	:	07/08/2007

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