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NPI Code Detail

MEDICARE: PEYTON R DEARBORN M.D.

MEDICARE: PEYTON R DEARBORN M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialist25MA06079200NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1346243219
Entity Type Code : Individual
Provider Name (Legal Business Name) : PEYTON R DEARBORN M.D.
Provider Business Mailing Address
First Line : PO BOX 48076
Second Line :
City : NEWARK
State : NJ
Zip : 07101-4876
Country : US
Telephone Number : 201-804-2800
Fax Number :
Provider Business Practice Location Address
First Line : 1 E NEW YORK AVE
Second Line :
City : SOMERS POINT
State : NJ
Zip : 08244-2340
Country : US
Telephone Number : 609-653-3500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2005
Last Update Date : 10/29/2008

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