Provider Demographics
NPI:1366438871
Name:HUNTINGTON, PETER P (MD)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:P
Last Name:HUNTINGTON
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 1:7246 JANUS PARK DR
Mailing Address - Street 2:CARDIAC REHAB
Mailing Address - City:LIVERPOOL
Mailing Address - State:NY
Mailing Address - Zip Code:13088-4839
Mailing Address - Country:US
Mailing Address - Phone:315-458-7171
Mailing Address - Fax:315-458-5715
Practice Address - Street 1:7246 JANUS PARK DR
Practice Address - Street 2:CARDIAC REHAB
Practice Address - City:LIVERPOOL
Practice Address - State:NY
Practice Address - Zip Code:13088-4839
Practice Address - Country:US
Practice Address - Phone:315-458-7171
Practice Address - Fax:315-458-5715
Is Sole Proprietor?:No
Enumeration Date:2005-09-21
Last Update Date:2010-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY103284207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
B81531Medicare UPIN
NYDD1969Medicare PIN