Provider Demographics
NPI:1487837399
Name:PETERS, JULIE ELIZABETH (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:ELIZABETH
Last Name:PETERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 CHAPEL ST
Mailing Address - Street 2:SUITE 1212
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06510-2802
Mailing Address - Country:US
Mailing Address - Phone:203-773-3440
Mailing Address - Fax:
Practice Address - Street 1:900 CHAPEL ST
Practice Address - Street 2:SUITE 1212
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510-2802
Practice Address - Country:US
Practice Address - Phone:203-773-3440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-13
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0387962084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry