Provider Demographics
NPI:1194993865
Name:WEBB, PETER R (RPH)
Entity type:Individual
Prefix:MR
First Name:PETER
Middle Name:R
Last Name:WEBB
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 CHELSEA DR
Mailing Address - Street 2:
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-2908
Mailing Address - Country:US
Mailing Address - Phone:631-422-3177
Mailing Address - Fax:
Practice Address - Street 1:19 CHELSEA DR
Practice Address - Street 2:
Practice Address - City:SYOSSET
Practice Address - State:NY
Practice Address - Zip Code:11791-2908
Practice Address - Country:US
Practice Address - Phone:631-422-3177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-15
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038532183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist