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General NPI Number Information
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NPI Number | 1134184237
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Entity Type | Individual
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Provider Name | BARRY D PESKIN MD
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Gender | Male
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Dates
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Enumeration Date | 04/20/2006
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Last Update Date | 09/23/2021
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Provider Practice Location Address
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Address Line | 9820 VITRAIL LN
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City | DELRAY BEACH
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State | FL
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Zip | 33446-3816
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Country | US
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Telephone | 216-973-2844
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Fax |
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Provider Business Mailing Address
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Address Line | 10831 REDLAKE ISLE
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City | BOYNTON BEACH
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State | FL
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Zip | 33473-7861
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Country | US
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Telephone | 216-973-2844
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 35059849P
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | ME79290
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License Number State | FL
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