Provider Demographics
NPI:1851460752
Name:BRECHER, PETER J (PHD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:J
Last Name:BRECHER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:258 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01757-2525
Mailing Address - Country:US
Mailing Address - Phone:508-473-5888
Mailing Address - Fax:
Practice Address - Street 1:258 MAIN ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:MA
Practice Address - Zip Code:01757-2525
Practice Address - Country:US
Practice Address - Phone:508-473-5888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1840103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW01985Medicare ID - Type Unspecified
MAW67409Medicare UPIN