Provider Demographics
NPI:1619191335
Name:NIGRO, PETER JOHN (MD)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:JOHN
Last Name:NIGRO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:536 ATSION RD
Mailing Address - Street 2:
Mailing Address - City:SHAMONG
Mailing Address - State:NJ
Mailing Address - Zip Code:08088-9533
Mailing Address - Country:US
Mailing Address - Phone:609-268-3687
Mailing Address - Fax:
Practice Address - Street 1:770 SUMNEYTOWN PIKE
Practice Address - Street 2:
Practice Address - City:WEST POINT
Practice Address - State:PA
Practice Address - Zip Code:19486
Practice Address - Country:US
Practice Address - Phone:215-652-7022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4192002083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine