Individual
HARALD W PETERSEN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
300 2ND AVE, LONG BRANCH, NJ 07740-6303
(732) 923-6540
(732) 923-6536
Mailing address
PO BOX 15378, NEWARK, NJ 07192-5378
(732) 923-6540
(732) 923-6536
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MA02201800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2081300
—
NJ
Enumeration date
05/09/2006
Last updated
07/08/2007
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