Provider Demographics
NPI:1295066181
Name:SACCONE, PETER JOSEPH (DO)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:JOSEPH
Last Name:SACCONE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:42 E LAUREL RD
Mailing Address - Street 2:SUITE 3100
Mailing Address - City:STRATFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08084-1354
Mailing Address - Country:US
Mailing Address - Phone:856-566-6859
Mailing Address - Fax:856-566-6952
Practice Address - Street 1:222 NEW RD STE 201
Practice Address - Street 2:
Practice Address - City:LINWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08221-1281
Practice Address - Country:US
Practice Address - Phone:609-788-8593
Practice Address - Fax:609-904-6929
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-18
Last Update Date:2019-08-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY04509207RP1001X, 207R00000X, 207RC0200X
NJ25MB0902500207R00000X
NJ25MB09025200207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine