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General NPI Number Information
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NPI Number | 1093914350
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Entity Type | Organization
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Legal Business Name | PEGGY ANN GARGIAN M D P C
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Dates
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Enumeration Date | 07/16/2007
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Last Update Date | 05/23/2008
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Provider Practice Location Address
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Address Line | 458 BAY RIDGE PKWY
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City | BROOKLYN
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State | NY
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Zip | 11209-2702
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Country | US
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Telephone | 718-238-4157
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Fax | 718-720-1684
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Provider Business Mailing Address
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Address Line | 71 TODT HILL RD STE 201
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City | STATEN ISLAND
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State | NY
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Zip | 10314-4534
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Country | US
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Telephone | 718-720-1030
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Fax | 718-720-1684
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Authorized Official
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Title or Position | OWNER
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Name | DR. PEGGY ANN GARGIAN
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Credential | M D P C
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Telephone | 718-720-1030
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 173000000X
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Taxonomy Name | Legal Medicine
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License Number | 151980
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License Number State | NY
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