Provider Demographics
NPI:1972553436
Name:CORRADO, PETER (DO)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:
Last Name:CORRADO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 MECHANIC ST
Mailing Address - Street 2:
Mailing Address - City:CAPE MAY COURT HOUSE
Mailing Address - State:NJ
Mailing Address - Zip Code:08210-2224
Mailing Address - Country:US
Mailing Address - Phone:609-463-9960
Mailing Address - Fax:609-463-9980
Practice Address - Street 1:108 MECHANIC ST
Practice Address - Street 2:
Practice Address - City:CAPE MAY COURT HOUSE
Practice Address - State:NJ
Practice Address - Zip Code:08210-2224
Practice Address - Country:US
Practice Address - Phone:609-463-9960
Practice Address - Fax:609-463-9980
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-12
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB49801207Q00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2095495OtherUNITED HEALTHCARE
NJ0098949000OtherKEYSTONE HEALTH PLAN
NJ0098949000OtherAMERIHEALTH
NJ7341223OtherAETNA
NJP2522550OtherOXFORD
NJ080171611OtherRAILROAD MEDICARE
NJ1140431OtherHORIZON MERCY HEALTH PLAN
NJ0098949000OtherKEYSTONE HEALTH PLAN
NJD19471Medicare UPIN
NJ2494809Medicaid
NJ418444Medicare PIN