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General NPI Number Information
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NPI Number | 1477823185
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Entity Type | Organization
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Legal Business Name | JON ALLAN PEET MD, LLC
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Dates
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Enumeration Date | 01/11/2012
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Last Update Date | 02/06/2012
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Provider Practice Location Address
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Address Line | 1802 BERLIN RD
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City | CHERRY HILL
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State | NJ
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Zip | 08003-3736
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Country | US
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Telephone | 215-327-9517
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Fax |
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Provider Business Mailing Address
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Address Line | 1802 BERLIN RD
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City | CHERRY HILL
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State | NJ
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Zip | 08003-3736
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Country | US
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Telephone | 215-327-9517
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JON ALLAN PEET
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Credential | M.D.
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Telephone | 215-327-9517
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 25MA09005100
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License Number State | NJ
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