Provider Demographics
NPI:1043746951
Name:ROMOFF, PETER (DO)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:
Last Name:ROMOFF
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:339 6TH AVE FL 5
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15222-2518
Mailing Address - Country:US
Mailing Address - Phone:412-560-8762
Mailing Address - Fax:412-281-7012
Practice Address - Street 1:339 6TH AVE FL 5
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15222-2518
Practice Address - Country:US
Practice Address - Phone:412-560-8762
Practice Address - Fax:412-281-7012
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2024-10-15
Deactivation Date:2021-05-18
Deactivation Code:
Reactivation Date:2021-06-01
Provider Licenses
StateLicense IDTaxonomies
PAOS023289207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine