Provider Demographics
NPI:1619915253
Name:PEYSER, IRVING GERALD (MD)
Entity Type:Individual
Prefix:DR
First Name:IRVING
Middle Name:GERALD
Last Name:PEYSER
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 1:3699 ROUTE 46
Mailing Address - Street 2:
Mailing Address - City:PARSIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07054
Mailing Address - Country:US
Mailing Address - Phone:973-334-0224
Mailing Address - Fax:973-334-0208
Practice Address - Street 1:3699 ROUTE 46
Practice Address - Street 2:
Practice Address - City:PARSIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07054
Practice Address - Country:US
Practice Address - Phone:973-334-0224
Practice Address - Fax:973-334-0208
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-04
Last Update Date:2010-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27601208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2807602Medicaid
PE161999 NJMedicare PIN
NJ2807602Medicaid