Provider Demographics
NPI:1932164910
Name:HO, PETER YING CHUEN (MD, FACR)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:YING CHUEN
Last Name:HO
Suffix:
Gender:M
Credentials:MD, FACR
Other - Prefix:
Other - First Name:PETER
Other - Middle Name:Y
Other - Last Name:HO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:94 HOBART AVE
Mailing Address - Street 2:
Mailing Address - City:SUMMIT
Mailing Address - State:NJ
Mailing Address - Zip Code:07901-2810
Mailing Address - Country:US
Mailing Address - Phone:732-223-1760
Mailing Address - Fax:
Practice Address - Street 1:94 HOBART AVE
Practice Address - Street 2:
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901-2810
Practice Address - Country:US
Practice Address - Phone:732-223-1760
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-20
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY223584-12085R0001X
NJ25MA049690002085R0001X
PAMD4187082085R0001X, 2085R0001X
OH35.0411832085R0001X, 2085R0001X
WV239082085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3670601Medicaid
FH0653192OtherDEA
NJBH0930885OtherDEA
OHFH0653192OtherDEA
NJ3670601Medicaid
OH0477505Medicaid
WV381006804Medicaid
KY64781677Medicaid
PA100764PDBMedicare PIN
OHHO4284421Medicare PIN
D19832Medicare UPIN
OH0477505Medicaid
KY64781677Medicaid
WV381006804Medicaid