Individual
DR. ELIZABETH MARIE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
103 W SAINT CLAIR ST RM 1A, WARREN, PA 16365-2187
(814) 726-2020
(814) 726-1215
Mailing address
103 W SAINT CLAIR ST RM 1A, WARREN, PA 16365-2187
(814) 726-2020
(814) 726-1215
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
002720
CT
152W00000X
Optometrist
1688
SC
152W00000X
Optometrist
4667
MA
152W00000X
Optometrist
Primary
OEG003245
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04-2945394
UNITED HEALTHCARE
MA
05
—
0718441
—
MA
01
—
137525
FALLON
MA
01
—
214521-7908
CONNECTICARE
MA
01
—
43787
HEALTH NEW ENGLAND
MA
01
—
9845135
AETNA
MA
01
—
AA111986
HARVARD PILGRIM
MA
01
—
MA4667
EYEMED
MA
Enumeration date
07/31/2007
Last updated
06/06/2024
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