Individual
PETER G. POLOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
65 JAMES ST, EDISON, NJ 08820-3947
(732) 321-7010
(732) 744-5873
Mailing address
65 JAMES ST, EDISON, NJ 08820-3947
(732) 321-7010
(732) 744-5873
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
25MA07459300
NJ
207RP1001X
Pulmonary Disease Physician
Primary
25MA07459300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0041599
—
NJ
Enumeration date
07/28/2005
Last updated
07/21/2009
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