Provider Demographics
NPI:1639111537
Name:COTTONE, PETER F (PA)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:F
Last Name:COTTONE
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 MOUNT KEMBLE AVE
Mailing Address - Street 2:THEBAUD BUILDING, FOURTH FLOOR
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-5155
Mailing Address - Country:US
Mailing Address - Phone:973-267-2293
Mailing Address - Fax:973-267-3144
Practice Address - Street 1:1000 CRAWFORD PL STE 240
Practice Address - Street 2:
Practice Address - City:MOUNT LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054-3965
Practice Address - Country:US
Practice Address - Phone:889-828-5948
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00029900363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ090690Medicare ID - Type Unspecified
Q42928Medicare UPIN