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General NPI Number Information
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NPI Number | 1720118375
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Entity Type | Individual
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Provider Name | ROBERT M PESKIN D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 05/15/2014
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Provider Practice Location Address
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Address Line | 601 FRANKLIN AVENUE SUITE 225
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City | GARDEN CITY
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State | NY
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Zip | 11530-5742
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Country | US
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Telephone | 516-746-2434
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Fax | 516-746-3639
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Provider Business Mailing Address
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Address Line | 601 FRANKLIN AVE SUITE 225
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City | GARDEN CITY
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State | NY
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Zip | 11530-5795
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Country | US
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Telephone | 516-746-2434
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Fax | 516-746-3639
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 32715
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 7717
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 1223D0004X
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Taxonomy Name | Dental Anesthesiology
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License Number | 000248
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License Number State | NY
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