Individual
MR. PETER STATKEVICH JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BSN, RN
Contact information
Practice address
5151 PARK AVE, FAIRFIELD, CT 06825-1090
(203) 909-3560
Mailing address
17 SOUTHRIDGE RD, PROSPECT, CT 06712-1568
(203) 909-3560
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
821402
NY
Other
Enumeration date
01/05/2026
Last updated
01/05/2026
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