Individual
PETER VANGRONIGEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4802 10TH AVE, BROOKLYN, NY 11219-2916
(718) 283-8773
(718) 283-8796
Mailing address
GPO BOX 30058, NEW YORK, NY 10087-0058
(718) 283-8773
(718) 283-8796
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
133162
NY
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
133162
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00484937
—
NY
Enumeration date
11/13/2006
Last updated
06/17/2025
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