Provider Demographics
NPI:1366510042
Name:PELTZMAN, JEFFREY GERARD (DC)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:GERARD
Last Name:PELTZMAN
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 1:591 STATE HIGHWAY 34
Mailing Address - Street 2:
Mailing Address - City:MATAWAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07747-3049
Mailing Address - Country:US
Mailing Address - Phone:732-566-7658
Mailing Address - Fax:732-583-7847
Practice Address - Street 1:591 STATE ROUTE 34
Practice Address - Street 2:
Practice Address - City:MATAWAN
Practice Address - State:NJ
Practice Address - Zip Code:07747-3049
Practice Address - Country:US
Practice Address - Phone:732-566-7658
Practice Address - Fax:732-583-7847
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00357200111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJPE715099Medicare ID - Type Unspecified