MEDICARE: DR. ERIC PETERS DPM PC

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	213E00000X	Podiatrist	N003112	NY
2	213E00000X	Podiatrist	25MD00200900	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134100399
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERIC PETERS DPM PC

Provider Business Mailing Address
First Line	:	171 E POST RD
Second Line	:	STE 210-211
City	:	WHITE PLAINS
State	:	NY
Zip	:	10601
Country	:	US
Telephone Number	:	914-285-4444
Fax Number	:	914-285-4495

Provider Business Practice Location Address
First Line	:	222 MAMARONECK AVE STE 310
Second Line	:
City	:	WHITE PLAINS
State	:	NY
Zip	:	10605-1316
Country	:	US
Telephone Number	:	845-536-8826
Fax Number	:	914-828-0270

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

Provider Enumeration Date	:	11/07/2005
Last Update Date	:	11/18/2024

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