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General NPI Number Information
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NPI Number | 1083813836
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Entity Type | Organization
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Legal Business Name | PETER J HEFFER MDPC
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Dates
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Enumeration Date | 07/12/2007
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Last Update Date | 09/20/2007
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Provider Practice Location Address
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Address Line | 142 07 BOOTH MEM AVE
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City | FLUSHING
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State | NY
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Zip | 11355-5343
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Country | US
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Telephone | 718-961-5722
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Fax | 718-321-3099
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Provider Business Mailing Address
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Address Line | 14207 BOOTH MEMORIAL AVE
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City | FLUSHING
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State | NY
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Zip | 11355-5343
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Country | US
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Telephone | 718-961-5722
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Fax | 718-321-3099
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Authorized Official
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Title or Position | MEDICAL BILLER
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Name | MRS. DEBRA MARIE STROCK
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Credential |
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Telephone | 718-961-5722
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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