Organization
PERALTA PRIMARY CARE P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK FACTURA PERALTA M.D. (OWNER)
(646) 675-4671
Entity
Organization
Contact information
Practice address
4310 52ND ST, DAHON WELLNESS CENTER, WOODSIDE, NY 11377-4542
(718) 255-6229
(718) 255-1288
Mailing address
30 CRESCENT PL, YONKERS, NY 10704-2516
(914) 803-1151
(845) 512-8628
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
242019
NY
Other
Enumeration date
10/18/2013
Last updated
10/18/2013
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