| Peter Evan Protzel, DDS, MD | |
|
4277 Hempstead Tpke, Suite 214, Bethpage, NY 11714-5709 | |
| (516) 735-6505 | |
| (516) 735-3326 |
| Full Name | Peter Evan Protzel |
|---|---|
| Gender | Male |
| Speciality | Maxillofacial Surgery |
| Experience | 30 Years |
| Location | 4277 Hempstead Tpke, Bethpage, New York |
| Accepts Medicare Assignments | May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700802980 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 047168 (New York) | Secondary |
| 204E00000X | Oral & Maxillofacial Surgery | 047168 (New York) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Long Island Jewish Medical Center | New hyde park, NY | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| White Hall Dental, Pc | 2567820137 | 10 |
| Lenox Otolaryngology Head And Neck Surgery Pc | 3072699479 | 3 |
| Entity Name | Northwell Healthcare Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1215019500 PECOS PAC ID: 3971531039 Enrollment ID: O20070215000718 |
| Entity Name | Lenox Otolaryngology Head & Neck Surgery PC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1689871238 PECOS PAC ID: 3072699479 Enrollment ID: O20080326000275 |
| Entity Name | Black Hall Dental PC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1356091516 PECOS PAC ID: 6901283308 Enrollment ID: O20220524000597 |
| Entity Name | White Hall Dental, PC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1376268821 PECOS PAC ID: 2567820137 Enrollment ID: O20230614002923 |
| Mailing Address | Practice Location Address |
|---|---|
| Peter Evan Protzel, DDS, MD 4277 Hempstead Turnpike, Suite 214, Bethpage, NY 11714 Ph: (516) 735-6505 | Peter Evan Protzel, DDS, MD 4277 Hempstead Tpke, Suite 214, Bethpage, NY 11714-5709 Ph: (516) 735-6505 |