Provider Demographics
NPI:1215946249
Name:ARNETT, PETER ANDREW
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:ANDREW
Last Name:ARNETT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 MOORE BLDG
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY PARK
Mailing Address - State:PA
Mailing Address - Zip Code:16802-3103
Mailing Address - Country:US
Mailing Address - Phone:814-865-2191
Mailing Address - Fax:814-863-1331
Practice Address - Street 1:314 MOORE BLDG
Practice Address - Street 2:
Practice Address - City:UNIVERSITY PARK
Practice Address - State:PA
Practice Address - Zip Code:16802-3103
Practice Address - Country:US
Practice Address - Phone:814-865-2191
Practice Address - Fax:814-863-1331
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS009119L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA75990OtherCIGNA BEHAVIORAL HEALTH
PAA334449BOtherEMPIRE BLUE CROSS BLUE SHIELD
PA100740OtherCOMMUNITY CARE BEHAVORAL HEALTH
PA1434927OtherHIGHMARK BLUE SHIELD
PA057222KV5Medicare PIN