Individual
DR. MONTE H PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
275 8TH AVE, NEW YORK, NY 10011-1611
(212) 463-0102
(212) 463-0952
Mailing address
PO BOX 95000-2433, PHILADELPHIA, PA 19195-2433
(212) 463-0101
(212) 463-0952
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
150010
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00835378
—
NY
Enumeration date
02/22/2007
Last updated
09/17/2012
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