Kenneth S Peterson NP

NPI 1194744896 - Nurse Practitioner - 363L00000X

NPI Details
NPI 1194744896
Gender Male
Enumeration Date 07/19/2006
Last Updated 05/26/2009
Entity Type Individual
Active Over 10 years ago
Practice Location
116 BELMONT ST
SUITE 11
WORCESTER MA, 01605-2964, US
Phone (508) 334-1102
Fax
Business Location
PO BOX 415348
BOSTON MA, 02241-5348, US
Phone
Fax
Toxanomy
Taxonomy Code 363L00000X
License State Massachusetts
License Number 192039
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According to our database, Mr. Kenneth S Peterson NP NPI is 1194744896, taxonomy code is 363L00000X and license number is 192039, license state is located at Massachusetts. Kenneth S Peterson NP physically located at 116 Belmont St, Worcester MA, 01605-2964. NPI Number Kenneth S Peterson NP has the Individual type.

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1194744896 NPI number is provided on an as is basis without warranty of any kind. 1194744896 is maintained by the National Plan & Provider Enumeration System. The contents of Kenneth S Peterson NP are for informational purposes only.