Provider Demographics
NPI:1033348891
Name:PRIETO, PETER ANTHONY (MD)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:ANTHONY
Last Name:PRIETO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UNIVERISTY OF ROCHESTER MEDICAL CENTER, DEPT OF SURGERY
Mailing Address - Street 2:601 ELMWOOD AVE, BOX SURG
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642
Mailing Address - Country:US
Mailing Address - Phone:585-276-3332
Mailing Address - Fax:585-273-2859
Practice Address - Street 1:601 ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14642-4009
Practice Address - Country:US
Practice Address - Phone:585-275-1611
Practice Address - Fax:585-273-1252
Is Sole Proprietor?:No
Enumeration Date:2009-07-14
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ01542086X0206X
NY2875272086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX336769001Medicaid
TX336769001Medicaid