Provider Demographics
NPI:1154538346
Name:PENINSULA HOSPITAL CENTER
Entity type:Organization
Organization Name:PENINSULA HOSPITAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DERECTOR OF MEDICAL EDUCATION
Authorized Official - Prefix:
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:
Authorized Official - Last Name:TEPLITZ
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:718-734-3020
Mailing Address - Street 1:100 W 93RD ST.
Mailing Address - Street 2:APT. 16C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025
Mailing Address - Country:US
Mailing Address - Phone:212-864-0970
Mailing Address - Fax:
Practice Address - Street 1:5115 BEACH CHANNEL DR
Practice Address - Street 2:
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691-1042
Practice Address - Country:US
Practice Address - Phone:718-743-2000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Not Answered282N00000XHospitalsGeneral Acute Care Hospital