Provider Demographics
NPI:1316108467
Name:ERIKSEN, PETER (AUD)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:
Last Name:ERIKSEN
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:326 SPALDING RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19803-2422
Mailing Address - Country:US
Mailing Address - Phone:570-441-9952
Mailing Address - Fax:
Practice Address - Street 1:2001 LINCOLN DR W
Practice Address - Street 2:SUITE E
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-1531
Practice Address - Country:US
Practice Address - Phone:856-596-9670
Practice Address - Fax:856-985-6302
Is Sole Proprietor?:No
Enumeration Date:2008-06-20
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YA00074300231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist