Individual
PETR BEZDICEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
70 HATFIELD LN, SUITE 101, GOSHEN, NY 10924-6734
(845) 294-8888
(845) 294-1669
Mailing address
PO BOX 809, GOSHEN, NY 10924-0809
(845) 294-8888
(845) 294-1669
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
223433
NY
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
223433
NY
207RP1001X
Pulmonary Disease Physician
Primary
223433
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02238360
—
NY
01
—
290014566
RAILROAD MEDICARE
NY
Enumeration date
01/12/2006
Last updated
05/02/2008
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