Provider Demographics
NPI:1659452605
Name:PEPER, KATHRYN (MD)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:PEPER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 HARTLEY FARMS RD
Mailing Address - Street 2:(ADMINISTRATIVE OFFICE ONLY)
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-7047
Mailing Address - Country:US
Mailing Address - Phone:973-539-3388
Mailing Address - Fax:973-539-3377
Practice Address - Street 1:9 HARTLEY FARMS RD
Practice Address - Street 2:(ADMINISTRATIVE OFFICE ONLY)
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-7047
Practice Address - Country:US
Practice Address - Phone:973-539-3388
Practice Address - Fax:973-539-3377
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2017-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA0052009207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJE81244Medicare UPIN
NJ665795UYDMedicare ID - Type Unspecified