Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VE0102X | Reproductive Endocrinologist | 25MB08055600 | NJ |
Y | 207VE0102X | Reproductive Endocrinologist | OS005607-L | PA |
NPI | 1083773121 |
---|---|
Provider Name | Dr. Albert Peters |
First Address | Allentown, PA 18104-6172 |
Second Address | Allentown, PA 18104 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2006 |
Last Update Date | 09/10/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F57562 | (02) | NJ |