DR. BERT PETERSEN (NPI# 1750323267) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750323267 |
| Entity Type | Individual |
| Full Name | DR. BERT PETERSEN |
| Credential | MD |
| Practice Address |
1133 Broadway New York NY 10010-7903 |
| Mailing Address |
100 Old Palisade Rd 3012 Fort Lee NJ 07024-7064 |
| Practice Telephone | 2122318104 |
| Enumeration Date | 2006-06-11 |
| Last Update Date | 2014-11-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086X0206X |
Surgery Specialization: Surgical Oncology |
195031 | NY | Allopathic & Osteopathic Physicians |
| Street Address |
1133 BROADWAY |
| City | NEW YORK |
| State | NY |
| Zip Code | 10010-7903 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083684096 | Anthony Gaudioso | Counselor | 1133 Broadway, Suite 1508, New York, NY 10010-7903 | 2006-01-23 |
| 1164036307 | Mary R Rom | Counselor | 1133 Broadway, New York, NY 10010-7903 | 2020-09-04 |
| 1740752161 | Knowledge Health Medical Services PC | Clinic/Center | 1133 Broadway, New York, NY 10010-7903 | 2018-12-24 |
| 1326589516 | Brent Piper | Counselor | 1133 Broadway, Suite 608, New York, NY 10010-7903 | 2017-03-20 |
| 1336591312 | Shimon R Bellis | Social Worker | 1133 Broadway, Suite 1028, New York, NY 10010-7903 | 2016-07-01 |
| 1699138578 | Brian Kenneth Mccormack | Social Worker | 1133 Broadway, Suite 540, New York, NY 10010 | 2016-03-30 |
| 1437515780 | Volker Schuetz | Psychologist | 1133 Broadway, Suite 913, New York, NY 10010-7903 | 2016-01-01 |
| 1558757682 | Jessica Brewer Nutrition | Dietitian, Registered | 1133 Broadway, Suite 1023, New York, NY 10010-7903 | 2015-04-15 |
| 1205223336 | Jessica Brewer | Dietitian, Registered | 1133 Broadway, Suite 1023, New York, NY 10010-7903 | 2015-04-15 |
| 1952793549 | Jean May Shum | Acupuncturist | 1133 Broadway, Suite 703, New York, NY 10010-9998 | 2015-02-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811502768 | Ayodeji Grace Oloke | Counselor | 1133 Broadway, Suite 640, New York, NY 10010 | 2020-09-08 |
| 1619589553 | Christine Belanga | Student in an Organized Health Care Education/Training Program | 71 West 23rd St, Suite 1400, New York, NY 10010 | 2020-08-21 |
| 1437779766 | Sunny Makhijani | Student in an Organized Health Care Education/Training Program | 423 E 23rd St, New York, Ny 10010, New York, NY 10010 | 2020-04-16 |
| 1528695004 | Marylee Ann Marre | Nurse Practitioner | 226 E 25th St Apt 3d, New York, NY 10010 | 2020-03-25 |
| 1750911632 | Repair Physical Therapy PC | Clinic/Center | 204 East 25th Street, Suite 1, New York, NY 10010 | 2020-01-20 |
| 1134789084 | Auth Acupuncture Pllc | Acupuncturist | 20 W.22nd St. Ground Floor, New York, NY 10010 | 2019-06-13 |
| 1649837113 | Metro Community Health Centers, Inc | Clinic/Center | 335 East 24th Street, Suite 1b, New York, NY 10010 | 2019-05-21 |
| 1144703687 | Kimmy Ramotar | Psychologist | 115 E 23rd Street, 3rd Floor, #1513, New York, NY 10010 | 2018-09-11 |
| 1922580406 | Hye Soo Kim | Dentist | 345 E 24th St. 4w, New York, NY 10010 | 2018-08-31 |
| 1487172482 | Dominique Ann Williams | Psychologist | 295 Park Ave South, Apt# 17pho, New York, NY 10010 | 2017-08-30 |
| Find all providers in zip 10010 | ||||
| Taxonomy Code | 2086X0206X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Surgical Oncology |
| A surgical oncologist is a well-qualified surgeon who has obtained additional training and experience in the multidisciplinary approach to the prevention, diagnosis, treatment, and rehabilitation of cancer patients, and devotes a major portion of his or her professional practice to these activities and cancer research. |
| Notes: Source: Society of Surgical Oncology, 2007 [1/1/2008: definition added, source added, 7/1/2009: definiition reformatted] Additional Resources: http://www.surgonc.org/ ; American Board of Medical Specialties, 2007, www.abms.org ; American Board of Surgery, 2007, http://www.absurgery.org/ Surgical oncology is a recognized fellowship subspecialty program of surgery. Separate board certification is not currently offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336620004 | Jianhong Winson Tan | Surgery | 1233 York Ave Apt 20n, New York, NY 10065-6342 | 2018-08-22 |
| 1811246382 | Iain James Nixon | Surgery | 1378 York Ave, Apt 1c, New York, NY 10021-3415 | 2012-08-30 |
| 1649551953 | Manuela J Junqueira | Surgery | 303 E 60th St Apt 24f, New York, NY 10022-1523 | 2011-08-31 |
| 1447554449 | John Mitchel Barry | Surgery | 1233 York Ave Apt 18n, New York, NY 10065-6342 | 2011-01-05 |
| 1255652608 | Daniel F Roses Md PC | Surgery | 530 1st Ave # 6b, New York, NY 10016-6402 | 2010-06-21 |
| 1780901918 | Noah Avram Cohen | Surgery | 19 E 98th St Fl 7, New York, NY 10029-6501 | 2010-04-28 |
| 1184885451 | Todd C Hanna | Surgery | 16 East 52nd St. Suite 1101, New York, NY 10022 | 2008-06-19 |
| 1790944114 | T Peter Kingham | Surgery | 52 Saint Marks Pl, Apt. 2c, New York, NY 10003-8103 | 2008-06-02 |
| 1013193507 | Michael Lowe | Surgery | 1275 York Ave # H-1206, New York, NY 10065-6007 | 2008-01-14 |
| 1851596142 | Paul H Schmidt | Surgery | 1176 Fifth Avenue, Box 1160, New York, NY 10029 | 2007-06-18 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.