Provider Demographics
NPI:1154452712
Name:LITWIN, PETER JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:JOHN
Last Name:LITWIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1610 ROUTE 88
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724-3018
Mailing Address - Country:US
Mailing Address - Phone:736-229-5654
Mailing Address - Fax:
Practice Address - Street 1:331 NEWMAN SPRINGS RD
Practice Address - Street 2:BLDG 1, 4TH FLOOR, STE 143
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-5688
Practice Address - Country:US
Practice Address - Phone:732-450-8050
Practice Address - Fax:732-676-6015
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2019-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA650692084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ100129Medicare PIN