Individual
PETER T WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, ATC, EMT
Contact information
Practice address
3385 VETERANS MEMORIAL HWY, RONKONKOMA, NY 11779-7660
(631) 737-2525
Mailing address
989 GARDINER DR, BAY SHORE, NY 11706-7634
(631) 665-0426
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
000823-1
NY
Other
Enumeration date
02/27/2007
Last updated
07/08/2007
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