Provider Demographics
NPI:1497815377
Name:KATHRYN PEPER MD LLC
Entity Type:Organization
Organization Name:KATHRYN PEPER MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:
Authorized Official - Last Name:PEPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-539-3388
Mailing Address - Street 1:9 HARTLEY FARMS RD
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-7047
Mailing Address - Country:US
Mailing Address - Phone:973-539-3388
Mailing Address - Fax:973-539-3377
Practice Address - Street 1:9 HARTLEY FARMS RD
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-7047
Practice Address - Country:US
Practice Address - Phone:973-539-3388
Practice Address - Fax:973-539-3377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2017-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05002900207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJE81244Medicare UPIN
NJ665795UYDMedicare PIN