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General NPI Number Information
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NPI Number | 1770674004
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Entity Type | Individual
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Provider Name | PETER G. MCGOVERN M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/28/2006
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Last Update Date | 02/14/2013
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Provider Practice Location Address
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Address Line | 249 EAST 58TH STREET REPRODUCTIVE ENDOCRINOLOGY OF SLR
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City | NEW YORK
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State | NY
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Zip | 10019
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Country | US
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Telephone | 212-523-7751
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 95000-3330 REPRODUCTIVE ENDOCRINOLOGY OF SLR
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City | PHILADELPHIA
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State | PA
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Zip | 19195-3330
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Country | US
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Telephone | 516-338-5300
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Fax | 516-333-1075
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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 | 207VE0102X
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Taxonomy Name | Reproductive Endocrinology Physician
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License Number | MA54273
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207VE0102X
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Taxonomy Name | Reproductive Endocrinology Physician
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License Number | 171501-1
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License Number State | NY
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