Individual
DR. MARYANN PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
65 JAMES ST, EDISON, NJ 08820-3947
(732) 321-7540
Mailing address
PO BOX 223727, PITTSBURGH, PA 15251-2727
(866) 560-2433
(301) 668-1742
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
25MA04674700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1534408
—
NJ
Enumeration date
01/20/2006
Last updated
09/22/2014
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