DR. WALTER PEGOLI NPI 1114954252

NPI Information

NPI: 1114954252
Provider Name: DR. WALTER PEGOLI
Classification: Surgery - 2086S0120X
Entity Type: Individual

Specialization: Pediatric Surgery

Address:
601 ELMWOOD AVE
BOX SURG
ROCHESTER, NY
ZIP 14642
Phone: (585) 275-4435
Get Directions

DR. Walter Pegoli is a pediatric surgery surgery in Rochester, NY. The provider is a surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents. DR. Walter Pegoli NPI is 1114954252. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

601 ELMWOOD AVE
BOX SURG
ROCHESTER, NY
ZIP 14642-410
Phone: (585) 275-4435
Fax: (585) 273-1252

The enumeration date for this NPI number is 6/26/2006 and was last updated on 6/30/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2086S0120X	Surgery	Pediatric Surgery	207965	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	01741551	MEDICAID	NEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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