Provider Demographics
NPI:1447332267
Name:WESTCHESTER MEDICINE FACULTY ASSOCIATES, PLLC
Entity type:Organization
Organization Name:WESTCHESTER MEDICINE FACULTY ASSOCIATES, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:PETERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-493-8370
Mailing Address - Street 1:95 GRASSLANDS RD
Mailing Address - Street 2:DEPT OF MEDICINE-MUNGER PAVILION
Mailing Address - City:VALHALLA
Mailing Address - State:NY
Mailing Address - Zip Code:10595-1646
Mailing Address - Country:US
Mailing Address - Phone:914-493-8370
Mailing Address - Fax:914-594-4434
Practice Address - Street 1:95 GRASSLANDS RD
Practice Address - Street 2:DEPT OF MEDICINE-MUNGER PAVILION
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595-1646
Practice Address - Country:US
Practice Address - Phone:914-493-8370
Practice Address - Fax:914-594-4434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2083P0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric MedicineGroup - Single Specialty