Provider Demographics
NPI:1447401252
Name:PETER M DUCH MD LLC
Entity Type:Organization
Organization Name:PETER M DUCH MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROXANA
Authorized Official - Middle Name:
Authorized Official - Last Name:PEEKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-522-3205
Mailing Address - Street 1:167 MAIN ST
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:METUCHEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08840-2771
Mailing Address - Country:US
Mailing Address - Phone:732-662-9845
Mailing Address - Fax:732-662-9848
Practice Address - Street 1:167 MAIN ST
Practice Address - Street 2:SUITE 1B
Practice Address - City:METUCHEN
Practice Address - State:NJ
Practice Address - Zip Code:08840-2771
Practice Address - Country:US
Practice Address - Phone:732-662-9845
Practice Address - Fax:732-662-9848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-10
Last Update Date:2012-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05938400207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJF33815Medicare UPIN
NJ140621Medicare PIN