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NPI Code Detail

MEDICARE: DR. PETER WILLIAM HENDERSON MD

MEDICARE:  DR. PETER WILLIAM HENDERSON  MD
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
1390200000XStudent in an Organized Health Care Education/Training ProgramNY
2208200000XPlastic Surgery Physician250095NY

General Provider Information

NPI Number : 1942467543
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PETER WILLIAM HENDERSON MD
Provider Business Mailing Address
First Line : 10 UNION SQ E FRNT 2L
Second Line :
City : NEW YORK
State : NY
Zip : 10003-3314
Country : US
Telephone Number : 212-241-5873
Fax Number :
Provider Business Practice Location Address
First Line : 10 UNION SQ E FRNT 2L
Second Line :
City : NEW YORK
State : NY
Zip : 10003-3314
Country : US
Telephone Number : 212-241-5873
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2008
Last Update Date : 06/01/2026

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Directions to “ DR. PETER WILLIAM HENDERSON MD” Practice Location

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