Provider Demographics
NPI:1831279496
Name:WINTER, PETER J (PA)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:J
Last Name:WINTER
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
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Mailing Address - Street 1:44 DARTMOUTH ST
Mailing Address - Street 2:
Mailing Address - City:WILLISTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11596-1810
Mailing Address - Country:US
Mailing Address - Phone:718-920-7000
Mailing Address - Fax:718-920-7000
Practice Address - Street 1:MMC - DEPT. OF CT SURGERY
Practice Address - Street 2:111 EAST 210TH STREET
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467
Practice Address - Country:US
Practice Address - Phone:718-920-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY005983363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant