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General NPI Number Information
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NPI Number | 1386688877
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Entity Type | Individual
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Provider Name | COURTNEY PECK PA
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Gender | Female
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Dates
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Enumeration Date | 06/15/2006
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Last Update Date | 12/23/2025
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Provider Practice Location Address
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Address Line | 20 GUEST ST STE 200
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City | BRIGHTON
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State | MA
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Zip | 02135-2040
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Country | US
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Telephone | 617-475-0496
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Fax | 213-265-9954
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Provider Business Mailing Address
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Address Line | 20 GUEST ST STE 200
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City | BRIGHTON
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State | MA
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Zip | 02135-2040
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Country | US
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Telephone | 617-475-0496
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Fax | 213-265-9954
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA1126
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License Number State | MA
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