National Provider Identifier
Blake Allan Peterson
Blake Allan Peterson is listed in the NPPES registry with a primary specialty of Student in an Organized Health Care Education/Training Program in Buffalo, NY and a listed phone number of (716) 829-2012.
Profile Overview
- NPI
- 1790480549
- Provider Type
- Individual
- Primary Specialty
- Student in an Organized Health Care Education/Training Program
- Enumeration Date
- April 03, 2023
- Last Updated
- April 03, 2023
Practice Location
- 955 Main St Ste 7230
- Buffalo, NY 14203-1121
Phone: (716) 829-2012
Specialties
- Student in an Organized Health Care Education/Training Program (390200000X)
Full Record
- NPI
- 1790480549
- Entity Type
- Individual
- Last Name
- Peterson
- First Name
- Blake
- Middle Name
- Allan
- Mailing Street Address
- 955 Main St Ste 7230
- Mailing City
- Buffalo
- Mailing State
- NY
- Mailing ZIP Code
- 14203-1121
- Mailing Country
- US
- Mailing Phone
- (716) 829-2012
- Mailing Fax
- (716) 829-3999
- Practice Street Address
- 955 Main St Ste 7230
- Practice City
- Buffalo
- Practice State
- NY
- Practice ZIP Code
- 14203-1121
- Practice Country
- US
- Practice Phone
- (716) 829-2012
- Practice Fax
- (716) 829-3999
- Enumeration Date
- April 03, 2023
- Last Updated
- April 03, 2023
- Sex
- Male
- Sole Proprietor
- No
- Certification Date
- April 01, 2023
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Student in an Organized Health Care Education/Training Program (390200000X)