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General NPI Number Information
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NPI Number | 1700825395
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Entity Type | Individual
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Provider Name | PETER LOGALBO M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/06/2006
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Last Update Date | 04/03/2019
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Provider Practice Location Address
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Address Line | 1 CROSFIELD AVENUE SUITE 201
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City | WEST NYACK
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State | NY
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Zip | 10994-2229
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Country | US
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Telephone | 845-727-1370
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Fax | 845-727-1377
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Provider Business Mailing Address
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Address Line | 660 WHITE PLAINS RD FL 4
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City | TARRYTOWN
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State | NY
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Zip | 10591-5139
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Country | US
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Telephone | 914-984-2546
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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 | 207KA0200X
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Taxonomy Name | Allergy Physician
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License Number | MA054270
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207KA0200X
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Taxonomy Name | Allergy Physician
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License Number | 140894
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License Number State | NY
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