Peter A Judge, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

1672631 Issued in NY

Practice address

320 Montauk Highway
South Bay OB GYN PC
West Islip, NY 11795-4401

Phone

(631) 587-2500

Fax

(631) 587-0292

NPI assigned

Oct 27, 2006

Last updated

Jun 16, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402876800000",
    "number": "1154407997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 RESEARCH WAY SUITE 204B",
            "address_2": "UNIVERSITY ASSOCIATES OBGYN",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "11733",
            "telephone_number": "631-615-8272",
            "fax_number": "631-350-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 MONTAUK HIGHWAY",
            "address_2": "SOUTH BAY OB GYN PC",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117954401",
            "telephone_number": "631-587-2500",
            "fax_number": "631-587-0292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUDGE",
        "first_name": "PETER",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2014-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "1672631",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "CP194",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124813",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "0200238",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Margarita Jurak, M.D.
• Imanjot Kahlon
• William M Kainzbauer, MD
• George Kakoulides, MD
• Natallia Kaliankevich, RN

• Obstetrics & Gynecology Physician in West Islip, NY
• Providers in West Islip, NY by specialty
• Obstetrics & Gynecology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.