Provider Demographics
NPI:1326499914
Name:PERNO, PETER JAMES JR (OD)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:JAMES
Last Name:PERNO
Suffix:JR
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:395 ROUTE 33
Mailing Address - Street 2:
Mailing Address - City:MERCERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-4401
Mailing Address - Country:US
Mailing Address - Phone:609-586-0273
Mailing Address - Fax:
Practice Address - Street 1:395 ROUTE 33
Practice Address - Street 2:
Practice Address - City:MERCERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08619-4401
Practice Address - Country:US
Practice Address - Phone:609-586-0273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-25
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIODTG00631152W00000X
NJ27OA00674000152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist