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NPI Profile for MICHAEL J PETERSEN in EAST SETAUKET, NY.
A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Vascular Surgery |
2086S0129X | 76 | Physician/Peripheral Vascular Disease | |
Specialist |
174400000X |
| NPI Number | 1902899057 |
|
| Status | Active | |
| Credentials | MD | |
| Entity | Individual | |
| Enumeration date | 08/24/2005 | |
| Last updated | 06/06/2016 - About 10 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
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| Hospital affiliation(s) |
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MICHAEL J PETERSEN
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MICHAEL J PETERSEN, MD