Individual ProviderPeter K WalshPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address29 Pembrook Dr, Stony Brook, NY 11790-2619(631) 689-7837PECOS EnrollmentBased on the most recent information from CMS, provider Peter K Walsh does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1396082194Provider TypeIndividualFull NameWalsh, Peter KCredentialPTGenderMaleSole ProprietorYesEnumeration Date1/14/2013Last Updated1/14/2013Contact InformationPractice LocationPractice Address29 Pembrook Dr, Stony Brook, NY 11790-2619Phone(631) 689-7837Fax(631) 689-7837Mailing LocationMailing Address29 Pembrook Dr, Stony Brook, NY 11790-2619Phone(631) 689-7837Fax(631) 689-7837Provider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense006949-1New York