Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath | NY |
NPI | 1588987614 |
---|---|
Provider Name | Mr. Winston Peterkin |
First Address | Brooklyn, NY 11226-3106 |
Second Address | Brooklyn, NY 11226-3106 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/03/2010 |
Last Update Date | 03/03/2010 |