Provider Demographics
NPI:1538234570
Name:KURZWEIL, PETER J (MD)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:J
Last Name:KURZWEIL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:GLEN COVE
Mailing Address - State:NY
Mailing Address - Zip Code:11542-2034
Mailing Address - Country:US
Mailing Address - Phone:516-671-7770
Mailing Address - Fax:516-671-6372
Practice Address - Street 1:235 FOREST AVE
Practice Address - Street 2:
Practice Address - City:GLEN COVE
Practice Address - State:NY
Practice Address - Zip Code:11542-2034
Practice Address - Country:US
Practice Address - Phone:516-671-7770
Practice Address - Fax:516-671-6372
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2007-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1378211207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00507891Medicaid
NY00507891Medicaid
NY34A62WS891Medicare PIN