Healthcare Provider Details

I. General information

NPI: 1497945950
Provider Name (Legal Business Name): PETER F GUIRGUIS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2007
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

78 CROMWELL AVE
STATEN ISLAND NY
10304-3912
US

IV. Provider business mailing address

78 CROMWELL AVE
STATEN ISLAND NY
10304-3912
US

V. Phone/Fax

Practice location:
  • Phone: 718-987-9175
  • Fax: 718-987-1642
Mailing address:
  • Phone: 718-987-9175
  • Fax: 718-987-1642

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number261060
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: