| Doctor Name: | ERIC PETERSON |
| NPI Number: | 1235446584 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | ASCP |
| License Number: | |
| Business Practice Address: | 31 E Butler Ave Fl 2 Ambler, PA - 190024510 |
| Business Phone Number: | 2156466406 |
| Business Fax Number: | |
| Mailing Address: | 610 Poinsettia St, ST AUGUSTINE |
| State: | FL |
| Postal Code: | 320806849 |
| Phone Number: | 9043477010 |
| Fax Number: | |
| NPI Enumeration Date: | 09/08/2010 |
| NPI Last Update Date: | 09/08/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 246RP1900X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
| Taxonomy Classification: | Technician, Pathology |
| Taxonomy Specialization: | Phlebotomy |
| Taxonomy Definition: | |