National Provider Identifier Database

MICHAEL J PETERSEN, MD – NPI #1902899057
Vascular Surgery

A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.

Contact Information

MICHAEL J PETERSEN, MD
4 TECHNOLOGY DR
SUITE 120
EAST SETAUKET, NY  11733-4068
Phone: 631-246-8289
Fax: 631-246-8294
Website:
Specialty Taxonomy Code
* Vascular Surgery 2086S0129X
Specialist 174400000X

* Indicates primary specialty

NPI Profile & details for MICHAEL J PETERSEN

NPI Number 1902899057
Credentials MD
Entity Individual
Enumeration date 08/24/2005
Last updated 06/06/2016 - About 10 years ago
Sole proprietor1 Yes
Identifiers
  • NY License #: 175936
  • NM Other: GHI PPO CBP 0103702
  • NM Other: 2110430 AETNA HEALTH PLANS
  • NY Other: 11347567803 1199 BENEFIT FUND
  • NY Other: 0714028004 CIGNA HEALTHCARE
  • NY Other: 2C4298 HEALTHNET
  • NY Other: CS1072 OXFORD HEALTH PLANS
  • NY Other: 990015026 RR MEDICARE
  • NY Other: S500051 SUFFOLK HEALTH PLANS
  • NY Other: 1261940 UNITED HEALTHCARE
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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