Provider Demographics
NPI:1063550416
Name:PEFFER, PATRICIA HALL (MD)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:HALL
Last Name:PEFFER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 415348
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-5348
Mailing Address - Country:US
Mailing Address - Phone:800-225-8885
Mailing Address - Fax:508-334-1977
Practice Address - Street 1:281 LINCOLN ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-2138
Practice Address - Country:US
Practice Address - Phone:774-329-9475
Practice Address - Fax:508-334-4655
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2016-03-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA237878207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1919781Medicaid
MA110088395AMedicaid
LA1919781Medicaid
LAE80816Medicare UPIN