Provider Demographics
NPI:1962628818
Name:PETER S MUELLER, M.D.,P.A
Entity Type:Organization
Organization Name:PETER S MUELLER, M.D.,P.A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:STERLING
Authorized Official - Last Name:MUELLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PA
Authorized Official - Phone:609-924-4061
Mailing Address - Street 1:601 EWING ST # A
Mailing Address - Street 2:SUITE B-3
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-2757
Mailing Address - Country:US
Mailing Address - Phone:609-924-4061
Mailing Address - Fax:609-497-0051
Practice Address - Street 1:601 EWING ST # A
Practice Address - Street 2:SUITE B-3
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-2757
Practice Address - Country:US
Practice Address - Phone:609-924-4061
Practice Address - Fax:609-497-0051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2010-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02676000103TP0016X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TP0016XBehavioral Health & Social Service ProvidersPsychologistPrescribing (Medical)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3651509Medicaid
NJD98909Medicare UPIN
NJ3651509Medicaid