Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0102X | Surgical Critical Care | 300291 | NY |
NPI | 1033278304 |
---|---|
Provider Name | Dr. Peter Rhee |
First Address | Hawthorne, NY 10532-2140 |
Second Address | Valhalla, NY 10595 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2006 |
Last Update Date | 30/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
300291 | NYS LICENSE (01) | NY |