Provider Demographics
NPI:1013013671
Name:LIBRE, PETER EUGENE (MD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:EUGENE
Last Name:LIBRE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 EAST AVE
Mailing Address - Street 2:SUITE 335
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06851-5014
Mailing Address - Country:US
Mailing Address - Phone:203-853-2020
Mailing Address - Fax:203-852-9553
Practice Address - Street 1:111 EAST AVE
Practice Address - Street 2:SUITE 335
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06851-5014
Practice Address - Country:US
Practice Address - Phone:203-853-2020
Practice Address - Fax:203-852-9553
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT033824207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001338244Medicaid
NY01554461Medicaid
CT001338244Medicaid
NY01554461Medicaid
F79003Medicare UPIN