MEDICARE: MR. PETER JOSEPH NESS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	BP20039266	TX
2	207W00000X	Ophthalmology Physician	52164	SC
3	207WX0110X	Pediatric Ophthalmology and Strabismus Specialist Physician	P9413	TX
4	207WX0110X	Pediatric Ophthalmology and Strabismus Specialist Physician	308276	NY

General Provider Information

NPI Number	:	1376817999
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. PETER JOSEPH NESS M.D.

Provider Business Mailing Address
First Line	:	920 ALBANY SHAKER RD
Second Line	:	SUITE 101
City	:	LATHAM
State	:	NY
Zip	:	12110
Country	:	US
Telephone Number	:	518-480-6216
Fax Number	:	518-533-6505

Provider Business Practice Location Address
First Line	:	920 ALBANY SHAKER RD
Second Line	:	SUITE 101
City	:	LATHAM
State	:	NY
Zip	:	12110
Country	:	US
Telephone Number	:	518-480-6216
Fax Number	:	518-533-6505

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/29/2012
Last Update Date	:	06/05/2024

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