Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 421288 | NY |
NPI | 1013444637 |
---|---|
Provider Name | Peggy Estime Roberts |
First Address | New Hyde Park, NY 11040-1402 |
Second Address | New Hyde Park, NY 11040-1402 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2017 |
Last Update Date | 03/12/2020 |