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Organization
PROPEAK SPORTS MEDICINE LLC
Active
Organization
PROPEAK SPORTS MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH W. WEBER-LOPEZ MD (AUTHORIZED OFFICIAL)
(631) 944-3020
Entity
Organization
Contact information
Practice address
158 E MAIN ST STE 3, HUNTINGTON, NY 11743-2988
(631) 944-3020
(631) 944-3022
Mailing address
158 E MAIN ST STE 3, HUNTINGTON, NY 11743-2988
(631) 944-3020
(631) 944-3022
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
—
—
Other
Enumeration date
01/31/2019
Last updated
01/31/2019
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