Healthcare Provider Details

I. General information

NPI: 1699688911
Provider Name (Legal Business Name): MURILO DE SA BARRETO CALLOU PEIXOTO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2026
Last Update Date: 09/26/2026
Certification Date: 09/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 E 60TH ST
NEW YORK NY
10022-1514
US

IV. Provider business mailing address

303 E 60TH ST
NEW YORK NY
10022-1514
US

V. Phone/Fax

Practice location:
  • Phone: 917-957-0876
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085N0904X
TaxonomyNuclear Radiology Physician
License Number347632
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number347632
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: