Individual
NEIL PETERSEN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
140 GRANDVIEW AVE, WATERBURY, CT 06708-2505
(203) 757-7000
(203) 591-1473
Mailing address
433 WOOD POND ROAD, CHESHIRE, CT 06410
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
029266
CT
Other
Enumeration date
06/13/2006
Last updated
07/08/2007
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