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General NPI Number Information
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NPI Number | 1659376713
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Entity Type | Individual
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Provider Name | PETER THOMAS ORLIC MD
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Gender | Male
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Dates
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Enumeration Date | 06/16/2005
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Last Update Date | 04/03/2023
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Provider Practice Location Address
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Address Line | 1 CEDAR CREST VILLAGE DR
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City | POMPTON PLAINS
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State | NJ
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Zip | 07444-2100
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Country | US
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Telephone | 973-831-3540
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Fax | 973-831-3503
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Provider Business Mailing Address
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Address Line | 5730 EXECUTIVE DR STE 230
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City | CATONSVILLE
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State | MD
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Zip | 21228-1762
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Country | US
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Telephone | 973-831-3540
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Fax | 973-831-3503
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 25MA6840000
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License Number State | NJ
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