Provider Demographics
NPI:1508812405
Name:SLOTWINER-NIE, PETER KJELD (MD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:KJELD
Last Name:SLOTWINER-NIE
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 1:688 WHITE PLAINS RD
Mailing Address - Street 2:SUITE 222
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-5059
Mailing Address - Country:US
Mailing Address - Phone:914-725-9115
Mailing Address - Fax:
Practice Address - Street 1:688 WHITE PLAINS RD
Practice Address - Street 2:SUITE 222
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-5059
Practice Address - Country:US
Practice Address - Phone:914-725-9115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY202742207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01690826Medicaid
NYG31258Medicare UPIN
NY01690826Medicaid