| Pedro J Roque Md Pllc | |
|
5 Wicks Rd Brentwood NY 11717-3508 | |
| (631) 435-2781 | |
| Not Available |
| Full Name | Pedro J Roque Md Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 5 Wicks Rd, Brentwood, New York |
| Authorized Official Name and Position | Pedro Roque (MD) |
| Authorized Official Contact | 6314352133 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pedro J Roque Md Pllc 5 Wicks Rd Brentwood NY 11717-3508 Ph: (631) 435-2781 | Pedro J Roque Md Pllc 5 Wicks Rd Brentwood NY 11717-3508 Ph: (631) 435-2781 |
| NPI Number | 1689730756 |
|---|---|
| Provider Enumeration Date | 12/30/2006 |
| Last Update Date | 03/24/2010 |
| Medicare PECOS PAC ID | 1850421975 |
|---|---|
| Medicare Enrollment ID | O20100615000859 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689730756 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Pedro J Roque |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275617987 PECOS PAC ID: 2860469665 Enrollment ID: I20040913000146 |
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