Provider Demographics
NPI:1316943962
Name:ARCHES, PETER JOCSON (MD)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:JOCSON
Last Name:ARCHES
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 1:2405 GENESEE ST
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13501
Mailing Address - Country:US
Mailing Address - Phone:315-798-9788
Mailing Address - Fax:315-798-9766
Practice Address - Street 1:2209 GENESEE ST
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13501
Practice Address - Country:US
Practice Address - Phone:315-798-9788
Practice Address - Fax:315-798-9766
Is Sole Proprietor?:No
Enumeration Date:2005-06-28
Last Update Date:2012-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0020875207L00000X
NY143331207L00000X
MA46221207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
12033451OtherCAQH
MD684500200Medicaid
MD684500200Medicaid
A55175Medicare UPIN