Individual
PETER J SIEFKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
518 MONTAUK HWY, STE 102, AMAGANSETT, NY 11930
(631) 267-5373
(631) 267-5376
Mailing address
57 HAMPTON ROAD, STE 201, SOUTHAMPTON, NY 11968
(631) 283-1126
(631) 283-7496
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
005732
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02175175
—
NY
Enumeration date
03/23/2007
Last updated
12/05/2016
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