Provider Demographics
NPI:1518143593
Name:PEREGOY, DAVID ALBERT JR (RT)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:ALBERT
Last Name:PEREGOY
Suffix:JR
Gender:M
Credentials:RT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4520 BROOKRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23832-7018
Mailing Address - Country:US
Mailing Address - Phone:804-310-8574
Mailing Address - Fax:
Practice Address - Street 1:8903 THREE CHOPT RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23229-4614
Practice Address - Country:US
Practice Address - Phone:804-288-1882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-21
Last Update Date:2008-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0117004106227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified