Healthcare Provider Details

I. General information

NPI: 1992880793
Provider Name (Legal Business Name): PETER ANTHONY D'ARIENZO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 01/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1615 NORTHERN BLVD STE 403
MANHASSET NY
11030-3033
US

IV. Provider business mailing address

1615 NORTHERN BLVD STE 403
MANHASSET NY
11030-3033
US

V. Phone/Fax

Practice location:
  • Phone: 516-627-0146
  • Fax: 516-365-4750
Mailing address:
  • Phone: 516-627-0146
  • Fax: 516-365-4750

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number187507
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: