Healthcare Provider Details

I. General information

NPI: 1710127956
Provider Name (Legal Business Name): PETER HOBEIKA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/28/2009
Last Update Date: 02/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 W 113TH ST APT 10A
NEW YORK NY
10025-8073
US

IV. Provider business mailing address

501 W 113TH ST APT 10A
NEW YORK NY
10025-8073
US

V. Phone/Fax

Practice location:
  • Phone: 201-724-7955
  • Fax:
Mailing address:
  • Phone: 201-724-7955
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number003277
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: