Provider Demographics
NPI:1831987932
Name:PERDIKOS, PETE
Entity type:Individual
Prefix:
First Name:PETE
Middle Name:
Last Name:PERDIKOS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 OVERLOOK RD
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07860-9773
Mailing Address - Country:US
Mailing Address - Phone:201-683-1816
Mailing Address - Fax:
Practice Address - Street 1:123 OVERLOOK RD
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:NJ
Practice Address - Zip Code:07860-9773
Practice Address - Country:US
Practice Address - Phone:201-683-1816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-28
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant