Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 007439 | NY |
NPI | 1386876829 |
---|---|
Provider Name | Dr. Peter John Sansone |
First Address | Brooklyn, NY 11215-1902 |
Second Address | Brooklyn, NY 11215-1902 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2009 |
Last Update Date | 18/08/2009 |