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NPI Code Detail

MEDICARE: DR. RAYMOND PESSO M.D.

MEDICARE: DR. RAYMOND PESSO M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207L00000XAnesthesiology Physician204886NY
2207L00000XAnesthesiology PhysicianME73854FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1114923372
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RAYMOND PESSO M.D.
Provider Business Mailing Address
First Line : 68 S SERVICE RD STE 350
Second Line :
City : MELVILLE
State : NY
Zip : 11747-2358
Country : US
Telephone Number : 516-945-3000
Fax Number :
Provider Business Practice Location Address
First Line : 27005 76TH AVE
Second Line :
City : NEW HYDE PARK
State : NY
Zip : 11040-1433
Country : US
Telephone Number : 718-470-7390
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2005
Last Update Date : 06/08/2026

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