Provider Demographics
NPI:1942366943
Name:LEMENTOWSKI, PETER WALTER (MD)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:WALTER
Last Name:LEMENTOWSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:100 WOODS RD FL 4
Mailing Address - Street 2:
Mailing Address - City:VALHALLA
Mailing Address - State:NY
Mailing Address - Zip Code:10595-1530
Mailing Address - Country:US
Mailing Address - Phone:914-789-2700
Mailing Address - Fax:914-789-2745
Practice Address - Street 1:100 WOODS RD FL 4
Practice Address - Street 2:
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595-1530
Practice Address - Country:US
Practice Address - Phone:914-789-2700
Practice Address - Fax:914-789-2745
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2021-12-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMT188816207XS0114X
NY245136207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery