MICHAEL JAMES PETERSEN

EAST SETAUKET, NY
NPI1902899057
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy2086S0129X 
(Licence: NY  175936)
Additional Taxonomies174400000X Specialist
(Licence: NY  175936)
Enumeration Date2005-08-24
Last Update Date2016-06-06
Business Address
-- MICHAEL JAMES PETERSEN M.D.
4 TECHNOLOGY DR SUITE 120
EAST SETAUKET, NY 11733-4068
Phone number: 631-246-8289
Mailing Address
-- MICHAEL JAMES PETERSEN M.D.
4 TECHNOLOGY DR SUITE 120
EAST SETAUKET, NY 11733-4068
Phone number: 631-246-8289
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