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General NPI Number Information
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NPI Number | 1861894982
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Entity Type | Organization
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Legal Business Name | SAINT PETER'S SPECIALTY PHYSICIANS, P.C.
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Dates
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Enumeration Date | 09/19/2014
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Last Update Date | 05/28/2025
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Provider Practice Location Address
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Address Line | 500 RIVER AVE STE 110
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City | LAKEWOOD
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State | NJ
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Zip | 08701-4738
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Country | US
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Telephone | 732-339-7880
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Fax |
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Provider Business Mailing Address
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Address Line | 254 EASTON AVENUE ATTN: MANAGED CARE DEPARTMENT
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City | NEW BRUNSWICK
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State | NJ
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Zip | 08901-1766
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Country | US
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Telephone | 732-565-5453
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Fax | 732-249-9572
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Authorized Official
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Title or Position | DIRECTOR
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Name | STACEY KNOWLES
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Credential |
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Telephone | 732-565-5453
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VM0101X
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Taxonomy Name | Maternal & Fetal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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