Organization
PEGASUS EMERGENCY MEDICINE TROY NY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELLIOT JUSTIN MD (PRESIDENT)
(856) 616-8100
Entity
Organization
Contact information
Practice address
1300 MASSACHUSETTS AVE, TROY, NY 12180
(856) 616-8100
(856) 616-1919
Mailing address
PO BOX 10730, WESTMINSTER, CA 92685-0730
(562) 809-3548
(562) 468-0726
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02618808
—
NY
Enumeration date
07/03/2006
Last updated
06/11/2008
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