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General NPI Number Information
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NPI Number | 1720496003
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Entity Type | Organization
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Legal Business Name | KFPA INC
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Dates
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Enumeration Date | 07/30/2014
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Last Update Date | 08/29/2014
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Provider Practice Location Address
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Address Line | 676 9TH AVE # 273A
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City | NEW YORK
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State | NY
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Zip | 10036-3611
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Country | US
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Telephone | 917-720-7677
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Fax |
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Provider Business Mailing Address
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Address Line | 676 9TH AVE # 273A
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City | NEW YORK
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State | NY
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Zip | 10036-3611
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Country | US
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Telephone | 917-720-7677
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Fax |
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Authorized Official
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Title or Position | ANESTHESIOLOGIST
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Name | ROSS D PEET
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Credential | MD
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Telephone | 917-720-7677
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 25MA08329200
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License Number State | NJ
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