Provider Demographics
NPI:1801811716
Name:ZEALE, PETER J (MD)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:J
Last Name:ZEALE
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 1:275 SEVENTH AVE
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:NY
Mailing Address - State:NY
Mailing Address - Zip Code:10001
Mailing Address - Country:US
Mailing Address - Phone:646-660-9998
Mailing Address - Fax:212-727-7396
Practice Address - Street 1:275 SEVENTH AVE
Practice Address - Street 2:3RD FLOOR
Practice Address - City:NY
Practice Address - State:NY
Practice Address - Zip Code:10001
Practice Address - Country:US
Practice Address - Phone:646-660-9998
Practice Address - Fax:212-727-7396
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY147791207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
B19864Medicare UPIN
90A661Medicare PIN