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NPI Code Detail

MEDICARE: PETER ACEVEDO

MEDICARE:   PETER  ACEVEDO
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
1104100000XSocial Worker084966-1NY

General Provider Information

NPI Number : 1255733762
Entity Type Code : Individual
Provider Name (Legal Business Name) : PETER ACEVEDO
Provider Business Mailing Address
First Line : 80 E 116TH ST
Second Line : #309
City : NEW YORK
State : NY
Zip : 10029-1128
Country : US
Telephone Number : 636-359-6479
Fax Number :
Provider Business Practice Location Address
First Line : 80 E 116TH ST
Second Line : #309
City : NEW YORK
State : NY
Zip : 10029-1128
Country : US
Telephone Number : 636-359-6479
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/16/2014
Last Update Date : 09/12/2022

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Directions to “ PETER ACEVEDO ” Practice Location

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