Provider Demographics
NPI:1255465233
Name:SYRE, PETER P JR (ED D)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:P
Last Name:SYRE
Suffix:JR
Gender:M
Credentials:ED D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1267 BOCKIUS AVE
Mailing Address - Street 2:
Mailing Address - City:ABINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19001-3801
Mailing Address - Country:US
Mailing Address - Phone:215-206-6354
Mailing Address - Fax:
Practice Address - Street 1:1352 EASTON RD
Practice Address - Street 2:
Practice Address - City:WARRINGTON
Practice Address - State:PA
Practice Address - Zip Code:18976-1852
Practice Address - Country:US
Practice Address - Phone:215-206-6354
Practice Address - Fax:215-343-7030
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS003215L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist