Provider Demographics
NPI:1154526382
Name:RICHARD A. PEINERT, MD, PC
Entity type:Organization
Organization Name:RICHARD A. PEINERT, MD, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:ALLAN
Authorized Official - Last Name:PEINERT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-593-2800
Mailing Address - Street 1:LYNNFIELD MEDICAL BUILDING
Mailing Address - Street 2:POST OFFICE SQUARE
Mailing Address - City:LYNNFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01940
Mailing Address - Country:US
Mailing Address - Phone:781-593-2800
Mailing Address - Fax:781-593-4224
Practice Address - Street 1:LYNNFIELD MEDICAL BUILDING
Practice Address - Street 2:POST OFFICE SQUARE
Practice Address - City:LYNNFIELD
Practice Address - State:MA
Practice Address - Zip Code:01940
Practice Address - Country:US
Practice Address - Phone:781-593-2800
Practice Address - Fax:781-593-4224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-18
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA36779174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAA30099Medicare UPIN
MAM13633Medicare ID - Type Unspecified