Provider Demographics
NPI:1841356433
Name:PETERS, NATALIA OLIVA (DPM)
Entity type:Individual
Prefix:MS
First Name:NATALIA
Middle Name:OLIVA
Last Name:PETERS
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Gender:F
Credentials:DPM
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Mailing Address - Street 1:820 THIERIOT AVENUE
Mailing Address - Street 2:7G
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10473-2810
Mailing Address - Country:US
Mailing Address - Phone:917-701-3883
Mailing Address - Fax:718-542-0270
Practice Address - Street 1:1 W 85TH ST
Practice Address - Street 2:SUITE 1C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-4134
Practice Address - Country:US
Practice Address - Phone:212-874-0564
Practice Address - Fax:212-496-8548
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
NYN006033213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
N006033OtherLICENSE NUMBER
NYPJ9201Medicare ID - Type Unspecified
NYV04899Medicare UPIN