Individual
MR. BRIAN THOMAS PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN, LP
Contact information
Practice address
50 W 86TH ST PH 1, NEW YORK, NY 10024-3621
(646) 729-5049
Mailing address
50 W 86TH ST PH 1, NEW YORK, NY 10024-3621
(646) 729-5049
Taxonomy
Speciality
Code
Description
License number
State
102L00000X
Psychoanalyst
Primary
000807
NY
163W00000X
Registered Nurse
547315
NY
Other
Enumeration date
04/26/2021
Last updated
04/26/2021
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