Individual
DR. BERT PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1133 BROADWAY, NEW YORK, NY 10010-7903
(212) 231-8104
Mailing address
100 OLD PALISADE RD, 3012, FORT LEE, NJ 07024-7064
Taxonomy
Speciality
Code
Description
License number
State
2086X0206X
Surgical Oncology Physician
Primary
195031
NY
Other
Enumeration date
06/11/2006
Last updated
11/19/2014
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