| Propeak Sports Medicine Llc | |
|
158 E Main St Ste 3 Huntington NY 11743-2988 | |
| (631) 944-3020 | |
| (631) 944-3022 |
| Full Name | Propeak Sports Medicine Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 158 E Main St Ste 3, Huntington, New York |
| Authorized Official Name and Position | Joseph W. Weber-lopez (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 6319443020 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Propeak Sports Medicine Llc 158 E Main St Ste 3 Huntington NY 11743-2988 Ph: (631) 944-3020 | Propeak Sports Medicine Llc 158 E Main St Ste 3 Huntington NY 11743-2988 Ph: (631) 944-3020 |
| NPI Number | 1932663259 |
|---|---|
| Provider Enumeration Date | 01/31/2019 |
| Last Update Date | 01/31/2019 |
| Medicare PECOS PAC ID | 4880935246 |
|---|---|
| Medicare Enrollment ID | O20190411001969 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932663259 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207QS0010X | Family Medicine - Sports Medicine | (* (Not Available)) | Primary |
| Provider Name | Joseph W Weber-lopez |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1134431554 PECOS PAC ID: 3779703285 Enrollment ID: I20141006000892 |
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