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DR. BERT PETERSEN MD NPI 1750323267


NPI Information

NPI: 1750323267
Provider Name: DR. BERT PETERSEN, MD
Classification: Surgery - 2086X0206X
Entity Type: Individual

Specialization: Surgical Oncology

PECOS Registration: Yes

Address:
1133 BROADWAY
NEW YORK, NY
ZIP 10010
Phone: (212) 231-8104
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DR. Bert Petersen, MD is a surgical oncology surgery in New York, NY with 37 years of experience. The provider is a surgical oncologist is a well-qualified surgeon who has obtained additional training and experience in the multidisciplinary approach to the prevention, diagnosis, treatment, and rehabilitation of cancer patients, and devotes a major portion of his or her professional practice to these activities and cancer research. DR. Bert Petersen, MD NPI is 1750323267. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: JOHNS HOPKINS UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:1987

The provider's business location address is:

1133 BROADWAY
NEW YORK, NY
ZIP 10010-903
Phone: (212) 231-8104

The NPI 1750323267 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/11/2006 and was last updated on 11/19/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12086X0206XSurgerySurgical Oncology195031NEW YORKYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1E85781MEDICARE UPIN
2086849MEDICARE ID-TYPE UNSPECIFIEDNEW JERSEY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.