Provider Demographics
NPI:1881868867
Name:PETERSON, ARNOLD (MD)
Entity type:Individual
Prefix:
First Name:ARNOLD
Middle Name:
Last Name:PETERSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:888 WHITE PLAINS RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:TRUMBULL
Mailing Address - State:CT
Mailing Address - Zip Code:06611-4552
Mailing Address - Country:US
Mailing Address - Phone:203-459-9666
Mailing Address - Fax:203-459-9698
Practice Address - Street 1:888 WHITE PLAINS RD
Practice Address - Street 2:SUITE 202
Practice Address - City:TRUMBULL
Practice Address - State:CT
Practice Address - Zip Code:06611-4552
Practice Address - Country:US
Practice Address - Phone:203-459-9666
Practice Address - Fax:203-459-9698
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-21
Last Update Date:2015-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT049528207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine