Provider Demographics
NPI:1992068399
Name:PETERSON, DEBORAH (TSHH)
Entity type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:
Last Name:PETERSON
Suffix:
Gender:F
Credentials:TSHH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1284 E 49TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-2125
Mailing Address - Country:US
Mailing Address - Phone:917-969-3025
Mailing Address - Fax:
Practice Address - Street 1:1284 E 49TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-2125
Practice Address - Country:US
Practice Address - Phone:917-969-3025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-20
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist