Provider Demographics
NPI:1982738886
Name:RICHMAN, PETER DENNIS (PHD)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:DENNIS
Last Name:RICHMAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:336 N 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08904-2742
Mailing Address - Country:US
Mailing Address - Phone:732-545-1010
Mailing Address - Fax:732-545-1010
Practice Address - Street 1:336 N 4TH AVE
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:08904-2742
Practice Address - Country:US
Practice Address - Phone:732-545-1010
Practice Address - Fax:732-545-1010
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35S100148900103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ353204000OtherMAGELLAN INSURANCE
NJ7176201OtherAETNA INSURANCE
NJ7176201OtherAETNA INSURANCE