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General NPI Number Information
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NPI Number | 1043738446
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Entity Type | Individual
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Provider Name | ALEXANDER PAUL PETERS PT, DPT, SCS, ATC
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Gender | Male
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Dates
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Enumeration Date | 09/06/2017
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Last Update Date | 12/27/2023
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Provider Practice Location Address
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Address Line | 5087 BROADWAY STE 100
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City | DEPEW
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State | NY
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Zip | 14043-4013
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Country | US
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Telephone | 716-354-3212
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 763
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City | BUFFALO
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State | NY
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Zip | 14231-0763
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Country | US
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Telephone | 716-202-2477
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 003454
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 046346
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1345441
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 8778
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License Number State | TX
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