Individual
DR. PETA-GAYE KENISHA PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
166 LYONS AVE FL 1, NEWARK, NJ 07112-2016
(973) 926-7282
(973) 923-2978
Mailing address
379 CAMPUS DR FL 4, SOMERSET, NJ 08873-1161
(732) 937-8939
(732) 418-8372
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
25MB10341500
NJ
208000000X
Pediatrics Physician
298839
NY
Other
Enumeration date
03/15/2018
Last updated
11/27/2024
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