Provider Demographics
NPI:1205349560
Name:PEEL, JAMES (LP)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:PEEL
Suffix:
Gender:M
Credentials:LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 LUNDE LN
Mailing Address - Street 2:
Mailing Address - City:HILLSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:12529-5141
Mailing Address - Country:US
Mailing Address - Phone:347-262-6899
Mailing Address - Fax:
Practice Address - Street 1:77 BLEECKER ST APT 111C
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012-1584
Practice Address - Country:US
Practice Address - Phone:347-262-6899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-08
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001009102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst