Individual
RYAN PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
20 YORK ST, FITKIN 615, NEW HAVEN, CT 06510-3220
(203) 688-4242
Mailing address
20 YORK ST, FITKIN 615, NEW HAVEN, CT 06510-3220
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
55295
CT
Other
Enumeration date
04/18/2012
Last updated
05/24/2021
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