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General NPI Number Information
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NPI Number | 1902876410
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Entity Type | Organization
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Legal Business Name | PETER GONTZES M. D. P. C.
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Dates
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Enumeration Date | 01/25/2006
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Last Update Date | 11/19/2007
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Provider Practice Location Address
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Address Line | 9231 57TH AVE
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City | ELMHURST
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State | NY
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Zip | 11373-5075
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Country | US
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Telephone | 718-592-1731
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Fax | 718-760-8262
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Provider Business Mailing Address
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Address Line | 9231 57TH AVE
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City | ELMHURST
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State | NY
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Zip | 11373-5075
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Country | US
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Telephone | 718-592-1731
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Fax | 718-760-8262
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Authorized Official
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Title or Position | PRESIDENT
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Name | PETER GONTZES
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Credential | M. D.
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Telephone | 718-592-1731
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | 151992
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License Number State | NY
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