Provider Demographics
NPI:1548216617
Name:PELLER, ALICIA SUE (MD)
Entity Type:Individual
Prefix:DR
First Name:ALICIA
Middle Name:SUE
Last Name:PELLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:163 BURLINGTON PATH RD
Mailing Address - Street 2:UNIT L
Mailing Address - City:CREAM RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08514-1622
Mailing Address - Country:US
Mailing Address - Phone:609-758-1100
Mailing Address - Fax:609-758-3188
Practice Address - Street 1:163 BURLINGTON PATH RD
Practice Address - Street 2:UNIT L
Practice Address - City:CREAM RIDGE
Practice Address - State:NJ
Practice Address - Zip Code:08514-1622
Practice Address - Country:US
Practice Address - Phone:609-758-1100
Practice Address - Fax:609-758-3188
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2022-03-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJMA47707208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics