Provider Demographics
NPI:1841283298
Name:HOETTE, PETRA (MD)
Entity type:Individual
Prefix:
First Name:PETRA
Middle Name:
Last Name:HOETTE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 WESCOTT DR STE 101
Mailing Address - Street 2:
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-4600
Mailing Address - Country:US
Mailing Address - Phone:908-788-6535
Mailing Address - Fax:908-788-6536
Practice Address - Street 1:1100 WESCOTT DR STE 101
Practice Address - Street 2:
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-4600
Practice Address - Country:US
Practice Address - Phone:908-788-6535
Practice Address - Fax:908-788-6536
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA74372207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ9043306Medicaid
NJ9043306Medicaid
NJ065250M5DMedicare ID - Type Unspecified