Provider Demographics
NPI:1194368944
Name:PETER RUZOHORSKY MD PC
Entity type:Organization
Organization Name:PETER RUZOHORSKY MD PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ARIELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:RITVO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-387-7628
Mailing Address - Street 1:890 BEDFORD AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11205-4251
Mailing Address - Country:US
Mailing Address - Phone:718-218-6089
Mailing Address - Fax:
Practice Address - Street 1:890 BEDFORD AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11205-4251
Practice Address - Country:US
Practice Address - Phone:718-218-6089
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-24
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care