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NPI Code Detail

MEDICARE: CAROLE JEAN PETERSON M.D.

MEDICARE: CAROLE JEAN PETERSON 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
1207V00000XObstetrics & Gynecology Physician147731NY

General Provider Information

NPI Number : 1639132798
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROLE JEAN PETERSON M.D.
Provider Business Mailing Address
First Line : HIGHLAND WOMENS HEALTH
Second Line : 1000 SOUTH AVE
City : ROCHESTER
State : NY
Zip : 14620
Country : US
Telephone Number : 585-602-1500
Fax Number :
Provider Business Practice Location Address
First Line : 2300 W JEFFERSON RD
Second Line :
City : PITTSFORD
State : NY
Zip : 14534-1090
Country : US
Telephone Number : 585-602-1500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2006
Last Update Date : 07/05/2023

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Directions to “ CAROLE JEAN PETERSON M.D.” Practice Location

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