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General NPI Number Information
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NPI Number | 1235459835
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Entity Type | Organization
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Legal Business Name | ROCHELLE L PECK MD,PC
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Dates
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Enumeration Date | 06/04/2010
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Last Update Date | 06/04/2010
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Provider Practice Location Address
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Address Line | 40 W 72ND ST SUITE A
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City | NEW YORK
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State | NY
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Zip | 10023-4119
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Country | US
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Telephone | 212-496-5870
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Fax | 212-724-2888
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Provider Business Mailing Address
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Address Line | 40 W 72ND ST SUITE A
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City | NEW YORK
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State | NY
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Zip | 10023-4119
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Country | US
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Telephone | 212-496-5870
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Fax | 212-724-2888
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROCHELLE L PECK
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Credential | MD
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Telephone | 212-496-5870
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 153620
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License Number State | NY
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