Provider Demographics
NPI:1083784292
Name:BUCKLEY, PETER J (MD)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:J
Last Name:BUCKLEY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:336 CENTRAL PARK W
Mailing Address - Street 2:APT. 5A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-7107
Mailing Address - Country:US
Mailing Address - Phone:718-920-7969
Mailing Address - Fax:718-882-3185
Practice Address - Street 1:MMC - DEPT. OF PSYCHIATRY
Practice Address - Street 2:3331 BAINBRIDGE AVENUE
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467
Practice Address - Country:US
Practice Address - Phone:718-920-7969
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1149952084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry