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General NPI Number Information
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NPI Number | 1699935304
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Entity Type | Organization
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Legal Business Name | PETER J.G. MARIS, M.D.
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Dates
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Enumeration Date | 06/16/2008
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Last Update Date | 06/16/2008
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Provider Practice Location Address
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Address Line | 230 HILTON AVE SUITE 118
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City | HEMPSTEAD
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State | NY
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Zip | 11550-8115
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Country | US
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Telephone | 516-481-1570
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Fax | 516-481-1786
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Provider Business Mailing Address
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Address Line | 230 HILTON AVE SUITE 118
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City | HEMPSTEAD
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State | NY
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Zip | 11550-8115
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Country | US
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Telephone | 516-481-1570
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Fax | 516-481-1786
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Authorized Official
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Title or Position | OWNER
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Name | PETER J.G. MARIS
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Credential | M.D.
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Telephone | 516-481-1570
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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 | 085829
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License Number State | NY
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