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Organization

D T PETERSON DPM PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DONALD THORGEIR PETERSON DPM (OWNER)
(516) 496-0900
Entity
Organization

Contact information

Practice address
8029 JERICHO TPKE, WOODBURY, NY 11797-1212
(516) 496-0900
(516) 496-0901
Mailing address
8029 JERICHO TPKE, WOODBURY, NY 11797-1212
(516) 496-0900
(516) 496-0901

Taxonomy

Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
N004585
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01349628-3
NY
Enumeration date
11/19/2010
Last updated
09/01/2024
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