Provider Demographics
NPI:1265521801
Name:SAYERS, PETER MAYO (MD)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:MAYO
Last Name:SAYERS
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:PO BOX 250
Mailing Address - Street 2:17 MILLER DRIVE
Mailing Address - City:CROWN POINT
Mailing Address - State:NY
Mailing Address - Zip Code:12928-0250
Mailing Address - Country:US
Mailing Address - Phone:518-597-3029
Mailing Address - Fax:518-597-3029
Practice Address - Street 1:17 MILLER DRIVE
Practice Address - Street 2:
Practice Address - City:CROWN POINT
Practice Address - State:NY
Practice Address - Zip Code:12928-0250
Practice Address - Country:US
Practice Address - Phone:518-597-3029
Practice Address - Fax:518-597-3029
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1818335207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01366421Medicaid
53799BMedicare ID - Type Unspecified
NY01366421Medicaid