Provider Demographics
NPI:1336474188
Name:DONALD P. PEYSER, M.D. P.A.
Entity Type:Organization
Organization Name:DONALD P. PEYSER, M.D. P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:PEYSER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-467-5800
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:
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:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-13
Last Update Date:2009-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MAO1961500207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJC56014Medicare UPIN
NJ458298Medicare PIN