Provider Demographics
NPI:1962622456
Name:IZMIRLY, PETER M (MD)
Entity type:Individual
Prefix:MR
First Name:PETER
Middle Name:M
Last Name:IZMIRLY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:343 E 30TH ST
Mailing Address - Street 2:APT 12L
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-6417
Mailing Address - Country:US
Mailing Address - Phone:212-447-4088
Mailing Address - Fax:
Practice Address - Street 1:560 FIRST AVENUE BUYON
Practice Address - Street 2:NYU SCHOOL OF MEDICINE/CLANCY LAB TH ROOM 407
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016
Practice Address - Country:US
Practice Address - Phone:212-263-0745
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY226294207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology