Provider Demographics
NPI:1801186408
Name:VANHEYST, PETER J JR (DO)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:J
Last Name:VANHEYST
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:207 HALLOCK RD
Mailing Address - Street 2:
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11790-3033
Mailing Address - Country:US
Mailing Address - Phone:631-689-6226
Mailing Address - Fax:631-675-0736
Practice Address - Street 1:207 HALLOCK RD
Practice Address - Street 2:
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11790-3033
Practice Address - Country:US
Practice Address - Phone:631-689-6226
Practice Address - Fax:631-675-0736
Is Sole Proprietor?:No
Enumeration Date:2011-04-15
Last Update Date:2016-02-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY275504208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics