Healthcare Provider Details

I. General information

NPI: 1194815993
Provider Name (Legal Business Name): PETER DICPINIGAITIS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 06/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MONTEFIORE MEDICAL PARK 1515 BLONDELL AVENUE, STE. 220
BRONX NY
10461
US

IV. Provider business mailing address

97 BYRAM RIDGE RD
ARMONK NY
10504-1211
US

V. Phone/Fax

Practice location:
  • Phone: 866-633-8255
  • Fax:
Mailing address:
  • Phone: 866-633-8255
  • Fax: 718-405-8278

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number176294
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number176294
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: