Tracy Peterson, R.P.A.C.
Physician Assistant in Islandia, NY. Individual provider (NPI-1).
NPI number1669563136
StatusActive
Last updated in NPPESOct 2, 2018
Details
- NPI
- 1669563136
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Tracy Peterson
- Credential
- R.P.A.C.
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 27, 2006
- Last updated
- Oct 2, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 008224 | NY | Yes |
Practice location
1770 Motor PkwyIslandia, NY 11749-5260
Phone 631-434-1770 · Fax 631-434-1254
Mailing address
3001 Expressway Dr NIslandia, NY 11749-5301
Phone 631-434-1770 · Fax 631-434-1254
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