WILLIAM A PETERSEN


Address: 10 Century Hill Dr, Latham, NY 12110-2162
Phone: 5187835563

WILLIAM A PETERSEN (NPI# 1881709079) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1881709079
Entity Type Individual
Full Name WILLIAM A PETERSEN
Credential M.D.
Practice Address 10 Century Hill Dr
Latham
NY 12110-2162
Practice Telephone 5187835563
Practice Fax Number 5187855708
Mailing Telephone 5187835563
Mailing Fax Number 5187855708
Enumeration Date 2006-08-20
Last Update Date 2007-07-08
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2080A0000X Pediatrics
Specialization: Adolescent Medicine
080697 NY Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
NY CDPHP 10002804 01
NY BS OF NENY 000401387001 01
NY 00392741 05
NY MVP 26208 01

Other Providers WILLIAM PETERSEN

NPI Name Taxonomy Address Enumeration
1124207808 William Frank Petersen Pharmacist 8 Magenta Ln, East Northport, NY 11731-5116 2007-10-30
1477690105 William Loftin Petersen Optometrist 34179 Golden Lantern St, Suite 201, Dana Point, CA 92629-2800 2007-01-31
1225050891 William M Petersen Family Medicine 614 Michigan Ave, Walker, MN 56484-1390 2006-07-24
1003250887 William Patrick Petersen Jr. Orthopaedic Surgery 1635 N George Mason Dr Ste 310, Arlington, VA 22205-3616 2013-04-23
1336276948 William Marc Petersen Dentist 2532 W Francis Ave, Spokane, WA 99205-7012 2007-02-28
1801933197 William Carl Petersen Jr. Pediatrics 1204 W Main St, Charlottesville, VA 22903-2824 2007-01-30
1124109400 William C Petersen Psychologist 5351 Delmar Blvd, Saint Louis, MO 63112-3146 2006-10-17
1902912504 William L Petersen Ophthalmology 48 Main St, Massena, NY 13662-1984 2006-08-23
1285674317 William C Petersen Anesthesiology 601 Childrens Ln, Norfolk, VA 23507-1910 2006-06-07
1770544579 William G. Petersen Internal Medicine 2401 S 31st St, Temple, TX 76508-0001 2006-03-31

Office Location

Street Address 10 CENTURY HILL DR
City LATHAM
State NY
Zip Code 12110-2162

Providers in the same location

NPI Name Taxonomy Address Enumeration
1699880864 Henry M. Neilley Pediatrics 10 Century Hill Dr, Latham, NY 12110-2162 2006-08-20
1154821247 Carrie Isensee Nurse Practitioner 10 Century Hill Dr, Latham, NY 12110-2162 2018-02-15
1992187223 Stephanie Guice Nurse Practitioner 10 Century Hill Dr, Latham, NY 12110-2162 2015-06-23
1790881886 Carol Phelan Nurse Practitioner 10 Century Hill Dr, Latham, NY 12110-2162 2006-09-15
1144335324 Maryla Warszawa-ambros Pediatrics 10 Century Hill Dr, Latham, NY 12110-2162 2006-08-20
1114032125 Sheela S Graney Pediatrics 10 Century Hill Dr, Latham, NY 12110-2162 2006-08-20
1427163435 David E Sherwood Pediatrics 10 Century Hill Dr, Latham, NY 12110-2162 2006-08-20

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1154963973 Bayley Archinal Physical Therapist 711 Troy-schenectady Road, Ste 216, Latham, NY 12110 2019-10-14
1114410701 Kimberly A. Hostig Licensed Clinical Social Worker Pllc Clinic/Center 8 Stanley Cir Ste 11, Latham, NY 12110 2018-06-08
1710477260 Colleen Phillips Physical Therapist 711 Troy Schenectady Rd Ste 216, Latham, NY 12110 2018-05-10
1528574779 Deborah Cannon Specialist 33c Waterford Avenue East, Latham, NY 12110 2017-12-26
1730600149 Michael Navarrete Dentist 231 Wade Road Ext Unit 101, Latham, NY 12110 2017-07-06
1316499452 Colonie Asc LLC Clinic/Center 207 Troy-schenectady Rd, Colonie, NY 12110 2016-10-25
1720539950 Tania M Durante Pharmacist 1057 Troy-schenectady Rd, Latham, NY 12110 2016-10-24
1417344987 New York Epilepsy Medicine, PC Clinic/Center 3 Lear Jet Ln Ste 203, Latham, NY 12110 2015-04-22
1346664752 Lauren Gannon Registered Nurse 95 Forts Ferry Road, Latham, NY 12110 2014-02-06
1649522756 Natasha Kapsaroff-ruiz Nurse Practitioner 654 Watervliet Shaker Rd, Latham, NY 12110 2012-10-12
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Taxonomy Information

Taxonomy Code 2080A0000X
Grouping Allopathic & Osteopathic Physicians
Classification Pediatrics
Specialization Adolescent Medicine

Taxonomy Definition

A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1699880864 Henry M. Neilley Pediatrics 10 Century Hill Dr, Latham, NY 12110-2162 2006-08-20
1336156223 Shaker Pediatrics PC Pediatrics 10 Century Hill Drive, Latham, NY 12110 2006-08-02
1144335324 Maryla Warszawa-ambros Pediatrics 10 Century Hill Dr, Latham, NY 12110-2162 2006-08-20
1114032125 Sheela S Graney Pediatrics 10 Century Hill Dr, Latham, NY 12110-2162 2006-08-20
1427163435 David E Sherwood Pediatrics 10 Century Hill Dr, Latham, NY 12110-2162 2006-08-20

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1902438039 Joanna Catherine Cross Pediatrics 6049 Transit Rd Ste 101, East Amherst, NY 14051-1803 2020-02-06
1720498306 Ashley M Yazdani Pediatrics 3950 East Robinson Road, Suite 205, West Amherst, NY 14228 2014-05-05
1699103879 Pediatric&adolescent Medical Care Pllc Pediatrics 450 76th St, Brooklyn, NY 11209-3204 2013-10-24
1962837377 Mariam Machabeli Pediatrics 765 Grand St, Brooklyn, NY 11211-5797 2013-09-05
1013352392 Pediatric Associates of Plainview Pediatrics 400 S Oyster Bay Rd Ste 207, Hicksville, NY 11801-3500 2013-05-01
1174876650 Theodore Fink Pediatrics 1 Rudolph Dr, Apt. 1s, Carle Place, NY 11514-1095 2012-10-20
1376804096 Melissa Ellen Dere Pediatrics 732 5th Ave, Brooklyn, NY 11232 2012-05-30
1386915544 Marvin Lieber Pediatrics 58 Sycamore Cir, Stony Brook, NY 11790-3147 2012-01-19
1508134578 Hicksville Pediatrics PC Pediatrics 535 S Broadway, Suite 1, Hicksville, NY 11801-5029 2011-12-06
1245523513 Khalida Itriyeva Pediatrics 410 Lakeville Rd Ste 108, New Hyde Park, NY 11042 2011-05-19
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City LATHAM
Zip Code 12110

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Dataset Information

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.

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