Smith, Peter
Smith, Peter is an sole proprietor health care provider with primary practice located at 207 Hallock Rd Suite 4, Stony Brook NY 11790-3033. He recently has 2 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Podiatrist, Podiatric Medicine & Surgery Service Providers / Sports Medicine. Podiatric Medicine & Surgery Service Providers / Podiatrist is his primary health care specialty. Smith, Peter can be contacted via phone (631) 689-2300.Contact Information
Primary practice address
207 Hallock Rd Suite 4
Stony Brook NY 11790-3033
Phone: (631) 689-2300
Fax: (631) 689-2078
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Podiatric Medicine & Surgery Service Providers / Podiatrist | 213E00000X | N004433 | New York |
| Podiatric Medicine & Surgery Service Providers / Sports Medicine | 213ES0000X | PD1905 | Massachusetts |
Profile Details
| NPI number | 1851361414 |
|---|---|
| LBN Legal business name | Smith, Peter |
| Credentials | Doctor of Podiatric Medicine (DPM) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 25th, 2006 |
| Last updated | Feb 12th, 2008 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1851361414 | NPPES |
| New York | Other | P1911509 | OXFORD |
| New York | MEDICAID | 01895183 | OXFORD |
| New York | Other | PO 44330 | OXFORD |
| New York | Other | NYB002451 | OXFORD |
| New York | Other | 6364966004 | OXFORD |
| New York | Other | 10259 | OXFORD |
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