Organization
THOMAS R PETERSON MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS R PETERSON MD (PRESIDENT)
(201) 525-0500
Entity
Organization
Contact information
Practice address
140 PROSPECT AVE, SUITE 18, HACKENSACK, NJ 07600
(201) 525-0500
(201) 525-1171
Mailing address
140 PROSPECT AVE, SUITE 18, HACKENSACK, NJ 07600
(201) 525-0500
(201) 525-1171
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
MA5194
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0154105
—
NJ
Enumeration date
09/25/2006
Last updated
08/22/2020
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