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1962622456 NPI number — PETER M. IZMIRLY M.D.

NPI Number: 1962622456
Health Care Provider/Practitioner: PETER M. IZMIRLY M.D.

Information about “1962622456” NPI (PETER M. IZMIRLY M.D.) exists in 1962622456 in HTML format HTML  |  1962622456 in plain Text format TXT  |  1962622456 in PDF (Portable Document Format) PDF  |  1962622456 in an XML format XML  formats.

NPI Number : 1962622456 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1962622456",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "IZMIRLY",
    "FirstName": "PETER",
    "MiddleName": "M.",
    "NamePrefix": "MR.",
    "NameSuffix": null,
    "Credential": "M.D.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "343 E 30TH ST",
    "SecondLineMailingAddress": "APT 12L",
    "MailingAddressCityName": "NEW YORK",
    "MailingAddressStateName": "NY",
    "MailingAddressPostalCode": "10016-6417",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "212-447-4088",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "560 FIRST AVENUE BUYON",
    "SecondLinePracticeLocationAddress": "NYU SCHOOL OF MEDICINE/CLANCY LAB TH ROOM 407",
    "PracticeLocationAddressCityName": "NEW YORK",
    "PracticeLocationAddressStateName": "NY",
    "PracticeLocationAddressPostalCode": "10016",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "212-263-0745",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "04/26/2007",
    "LastUpdateDate": "08/29/2022",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "207RR0500X",
        "TaxonomyName": "Rheumatology Physician",
        "LicenseNumber": "226294",
        "LicenseNumberStateCode": "NY",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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