Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | MD014417E | PA |
NPI | 1003859950 |
---|---|
Provider Name | Steven Peitzman |
First Address | Philadelphia, PA 19102-1321 |
Second Address | Philadelphia, PA 19107-1519 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2006 |
Last Update Date | 17/08/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E36191 | (02) | PA |