Provider Demographics
NPI:1427050459
Name:DIAMOND, PETER F (DO)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:F
Last Name:DIAMOND
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:107 TOWN CENTER RD
Mailing Address - Street 2:
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-2330
Mailing Address - Country:US
Mailing Address - Phone:610-994-0066
Mailing Address - Fax:484-681-4407
Practice Address - Street 1:119 HOLLAND CIRCLE DR
Practice Address - Street 2:
Practice Address - City:AMSTERDAM
Practice Address - State:NY
Practice Address - Zip Code:12010-7550
Practice Address - Country:US
Practice Address - Phone:518-843-4522
Practice Address - Fax:518-843-8306
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2015-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY136441207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00720214Medicaid
NY00720214Medicaid
NY38818BMedicare PIN