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NPI Code Detail

MEDICARE: DR. PETER MUNDA CH

MEDICARE: DR. PETER MUNDA CH
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
1111NX0800XOrthopedic ChiropractorX0002739-1NY

General Provider Information

NPI Number : 1467463588
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PETER MUNDA CH
Provider Business Mailing Address
First Line : 70 GLEN ST
Second Line : SUITE 380
City : GLEN COVE
State : NY
Zip : 11542-2858
Country : US
Telephone Number : 516-759-2424
Fax Number : 516-759-6627
Provider Business Practice Location Address
First Line : 70 GLEN ST
Second Line : SUITE 380
City : GLEN COVE
State : NY
Zip : 11542-2858
Country : US
Telephone Number : 516-759-2424
Fax Number : 516-759-6627
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2006
Last Update Date : 11/08/2007

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