Provider Demographics
NPI:1306137104
Name:COOMBS, PETER GARRETT (MD)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:GARRETT
Last Name:COOMBS
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 1:19 BRADHURST AVE STE 3750S
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:NY
Mailing Address - Zip Code:10532-2132
Mailing Address - Country:US
Mailing Address - Phone:914-313-3937
Mailing Address - Fax:
Practice Address - Street 1:19 BRADHURST AVE STE 3750S
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:NY
Practice Address - Zip Code:10532-2132
Practice Address - Country:US
Practice Address - Phone:914-313-3937
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-27
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY267576207W00000X
NH18060207W00000X
UT10785568-1205207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina SpecialistGroup - Single Specialty
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology