Provider Demographics
NPI:1720290729
Name:PETER J. BREINGAN MD & RICHARD L. DELUCA MD
Entity type:Organization
Organization Name:PETER J. BREINGAN MD & RICHARD L. DELUCA MD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:L
Authorized Official - Last Name:DELUCA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-505-2151
Mailing Address - Street 1:27 UNION SQ WEST
Mailing Address - Street 2:303
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-3305
Mailing Address - Country:US
Mailing Address - Phone:212-505-2151
Mailing Address - Fax:212-645-3165
Practice Address - Street 1:303 SECOND AVENUE
Practice Address - Street 2:15
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003
Practice Address - Country:US
Practice Address - Phone:212-505-2151
Practice Address - Fax:212-645-3165
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY571861Medicare ID - Type UnspecifiedPROVIDER ID#
NY97T811Medicare ID - Type UnspecifiedPROVIDER ID#
NY48Z941Medicare ID - Type UnspecifiedPROVIDER ID#