Provider Demographics
NPI:1336141290
Name:PEYSER, DONALD P (MD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:P
Last Name:PEYSER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 MILLBURN AVE
Mailing Address - Street 2:SUITE 104-A
Mailing Address - City:MILLBURN
Mailing Address - State:NJ
Mailing Address - Zip Code:07041-1737
Mailing Address - Country:US
Mailing Address - Phone:973-467-5800
Mailing Address - Fax:973-467-9163
Practice Address - Street 1:225 MILLBURN AVE
Practice Address - Street 2:SUITE 104-A
Practice Address - City:MILLBURN
Practice Address - State:NJ
Practice Address - Zip Code:07041-1737
Practice Address - Country:US
Practice Address - Phone:973-467-5800
Practice Address - Fax:973-467-9163
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJC56014Medicare UPIN
NJ458298Medicare ID - Type Unspecified