Individual
DR. D. PETER VANEENENAAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1571 WASHINGTON ST, SUITE 201, WATERTOWN, NY 13601-9304
(315) 782-1650
(315) 788-8547
Mailing address
1571 WASHINGTON ST, SUITE 201, WATERTOWN, NY 13601-9304
(315) 782-1650
(315) 788-8547
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
202886
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01670117
—
NY
Enumeration date
11/22/2005
Last updated
03/03/2016
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