Provider Demographics
NPI:1154344646
Name:PETER, ANDRAS (MD)
Entity type:Individual
Prefix:DR
First Name:ANDRAS
Middle Name:
Last Name:PETER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1030 SAINT GEORGES AVE
Mailing Address - Street 2:SUITE 103A
Mailing Address - City:AVENEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07001-1390
Mailing Address - Country:US
Mailing Address - Phone:732-596-1666
Mailing Address - Fax:732-596-0158
Practice Address - Street 1:1030 SAINT GEORGES AVE
Practice Address - Street 2:SUITE 103A
Practice Address - City:AVENEL
Practice Address - State:NJ
Practice Address - Zip Code:07001-1390
Practice Address - Country:US
Practice Address - Phone:732-596-1666
Practice Address - Fax:732-596-0158
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA72589207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8651205Medicaid
NJH42261Medicare UPIN
NJ049346Medicare ID - Type Unspecified