Individual
DR. PETER O KUPONIYI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2626 TILTON RD, EGG HARBOR TOWNSHIP, NJ 08234-1829
(609) 568-5000
(609) 568-5010
Mailing address
2626 TILTON RD, EGG HARBOR TOWNSHIP, NJ 08234-1829
(609) 568-5000
(609) 568-5010
Taxonomy
Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
MA059488
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5535603
—
NJ
Enumeration date
06/08/2006
Last updated
05/13/2011
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