Provider Demographics
NPI:1609809458
Name:PEPE, SALVATORE IV (DO)
Entity type:Individual
Prefix:
First Name:SALVATORE
Middle Name:
Last Name:PEPE
Suffix:IV
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:90 MATAWAN RD STE 302
Mailing Address - Street 2:
Mailing Address - City:MATAWAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07747-2653
Mailing Address - Country:US
Mailing Address - Phone:732-441-7177
Mailing Address - Fax:732-441-7165
Practice Address - Street 1:64 PRINCETON HIGHTSTOWN RD STE 2
Practice Address - Street 2:
Practice Address - City:WEST WINDSOR
Practice Address - State:NJ
Practice Address - Zip Code:08550-1103
Practice Address - Country:US
Practice Address - Phone:609-799-7009
Practice Address - Fax:609-799-7808
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB07025000207R00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8167001Medicaid
NJ8167001Medicaid
NJ036121Medicare PIN