Anne Virginia Peterson

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

010906 Issued in NY

Practice address

Stadium Rd
235 Counseling Ctr
Stony Brook, NY 11794-3100

Phone

(631) 632-6951

NPI assigned

Dec 4, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407914518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 QUAKER PATH",
            "city": "SETAUKET",
            "state": "NY",
            "postal_code": "117332213",
            "telephone_number": "631-689-6324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "STADIUM RD",
            "address_2": "235 COUNSELING CTR",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117943100",
            "telephone_number": "631-632-6951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "ANNE",
        "middle_name": "VIRGINIA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "010906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Muhammad Khurram Perwaiz
• Sasha-Lee Pestana, DO
• Sarah Rose Pestieau, M.D.
• Peter Smith, DPM, Facfao, PC
• Savannah Peters
• Jean Marie Peterson, AGNP-C
• Laura Petrozzo, RPA-C
• Anton Petuhovski, MD
• Robert Peyster, M.D.
• Andrew Xuan-Viet Pham, MD

• Clinical Psychologist in Stony Brook, NY
• Providers in Stony Brook, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.