MEDICARE: DR. PETER AKO PMHNP-BC

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
1	2084B0040X	Behavioral Neurology & Neuropsychiatry Physician	26NJ00708000	NJ

General Provider Information

NPI Number	:	1346769197
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PETER AKO PMHNP-BC

Provider Business Mailing Address
First Line	:	1680 VAN NESS TER
Second Line	:
City	:	UNION
State	:	NJ
Zip	:	07083-4033
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	40 UNION AVE STE 301
Second Line	:
City	:	IRVINGTON
State	:	NJ
Zip	:	07111-3290
Country	:	US
Telephone Number	:	862-849-2618
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/13/2017
Last Update Date	:	03/17/2018

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