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Individual

DR. ANTHONY PESCE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
450 WAVERLY AVE, PATCHOGUE, NY 11772-1555
(631) 444-6300
Mailing address
PO BOX 1559, STONY BROOK, NY 11790-0989
(631) 444-6300

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
188917
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01610966
NY
01
5450186
AETNA
NY
01
88K56
EMPIRE BC.BS
NY
Enumeration date
06/16/2006
Last updated
07/08/2007
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