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NPI Code Detail

MEDICARE: DR. MATTHEW DAVID PEGHER D.O.

MEDICARE:  DR. MATTHEW DAVID PEGHER  D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine PhysicianMB068499NJ
2207P00000XEmergency Medicine Physician234632NY
3207P00000XEmergency Medicine PhysicianOS-008384-LPA

General Provider Information

NPI Number : 1588613285
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MATTHEW DAVID PEGHER D.O.
Provider Business Mailing Address
First Line : 22 CRESTVIEW LN
Second Line :
City : SPARTA
State : NJ
Zip : 07871-3860
Country : US
Telephone Number : 973-726-3293
Fax Number :
Provider Business Practice Location Address
First Line : 1001 E 2ND ST
Second Line :
City : COUDERSPORT
State : PA
Zip : 16915-8161
Country : US
Telephone Number : 814-274-9300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/09/2006
Last Update Date : 06/08/2024

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Directions to “ DR. MATTHEW DAVID PEGHER D.O.” Practice Location

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