Individual
DR. PETER ANTHONY ANDOLINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
53 W 36TH ST RM 204, NEW YORK, NY 10018-7624
(212) 500-2163
Mailing address
53 W 36TH ST RM 204, NEW YORK, NY 10018-7624
(212) 500-2163
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
269587
NY
208600000X
Surgery Physician
0300434
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04108898
—
NY
05
—
7100508950
—
KY
Enumeration date
08/25/2011
Last updated
12/10/2024
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