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General NPI Number Information
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NPI Number | 1922029842
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Entity Type | Organization
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Legal Business Name | PETER M CORRADO PC
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Dates
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Enumeration Date | 07/23/2006
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Last Update Date | 02/18/2014
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Provider Practice Location Address
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Address Line | 108 N MAIN ST SUITE 3
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City | CAPE MAY COURT HOUSE
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State | NJ
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Zip | 08210-2190
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Country | US
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Telephone | 609-463-9960
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Fax | 609-463-9980
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Provider Business Mailing Address
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Address Line | 108 N MAIN ST SUITE 3
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City | CAPE MAY COURT HOUSE
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State | NJ
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Zip | 08210-2190
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Country | US
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Telephone | 609-463-9960
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Fax | 609-463-9980
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Authorized Official
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Title or Position | OWNER
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Name | PETER CORRADO
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Credential | D.O.
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Telephone | 609-463-9960
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MB49801
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License Number State | NJ
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