Provider Demographics
NPI:1093913006
Name:PERRONE, PETER (MD,DC)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:
Last Name:PERRONE
Suffix:
Gender:M
Credentials:MD,DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 MORRELL PL
Mailing Address - Street 2:
Mailing Address - City:GARFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07026-1223
Mailing Address - Country:US
Mailing Address - Phone:201-575-2535
Mailing Address - Fax:
Practice Address - Street 1:85 MORRELL PL
Practice Address - Street 2:
Practice Address - City:GARFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07026-1223
Practice Address - Country:US
Practice Address - Phone:201-575-2535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-11
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9395111N00000X
MO2021039159207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No111N00000XChiropractic ProvidersChiropractor