Provider Demographics
NPI:1306889001
Name:BERGER, PETER J (DC)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:J
Last Name:BERGER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 LAFAYETTE AVE
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07506
Mailing Address - Country:US
Mailing Address - Phone:973-423-9100
Mailing Address - Fax:973-423-1339
Practice Address - Street 1:219 LAFAYETTE AVE
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:NJ
Practice Address - Zip Code:07506
Practice Address - Country:US
Practice Address - Phone:973-423-9100
Practice Address - Fax:973-423-1339
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-13
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC04528111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor