Individual
PETER M BOLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
99 BEAUVOIR AVENUE, SUMMIT, NJ 07902-3533
(908) 522-2226
(908) 522-5269
Mailing address
99 BEAUVOIR AVENUE, SUMMIT, NJ 07902-3533
(908) 522-2226
(908) 522-5269
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MA53194
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6358802
—
NJ
Enumeration date
07/28/2006
Last updated
07/08/2007
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