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Individual

MAURICE ROBERT PETERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
170 EAST 77TH STREET, LOWER LEVEL, NEW YORK, NY 10075-1912
(212) 369-9200
(212) 369-5048
Mailing address
170 EAST 77TH STREET, LOWER LEVEL, NEW YORK, NY 10075-1912
(212) 369-9200
(212) 369-5048

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
044042
CT
2085R0202X
Diagnostic Radiology Physician
Primary
2300311
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1026716600001
PA
05
4599021 01
MD
Enumeration date
07/10/2006
Last updated
09/18/2012
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