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General NPI Number Information
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NPI Number | 1255428546
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Entity Type | Individual
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Provider Name | TRACY MARLENE PFEIFER MD
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Gender | Female
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Dates
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Enumeration Date | 10/06/2006
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Last Update Date | 02/18/2020
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Provider Practice Location Address
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Address Line | 969 PARK AVE
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City | NEW YORK
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State | NY
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Zip | 10028-0322
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Country | US
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Telephone | 212-860-0670
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Fax | 212-717-2701
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Provider Business Mailing Address
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Address Line | 1125 5TH AVENUE DOCTOR'S OFFICE
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City | NEW YORK
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State | NY
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Zip | 10128
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Country | US
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Telephone | 212-860-0670
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Fax | 212-861-0677
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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 | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 192707
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License Number State | NY
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