1811980808 NPI number — DR. H. MICHAEL PETER PH.D.

Table of content: DR. H. MICHAEL PETER PH.D. (NPI 1811980808)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811980808 NPI number — DR. H. MICHAEL PETER PH.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PETER
Provider First Name:
H.
Provider Middle Name:
MICHAEL
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PH.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1811980808
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/30/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6 BREVITY CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BINGHAMTON
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
13905-4114
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
607-729-5232
Provider Business Mailing Address Fax Number:
607-729-5232

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6 BREVITY CT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BINGHAMTON
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13905-4114
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
607-729-5232
Provider Business Practice Location Address Fax Number:
607-729-5232
Provider Enumeration Date:
08/25/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103T00000X , with the licence number:  4903 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 137232 . This is a "VALUE OPTIONS FOR HORIZONS OF NJ" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: Y022597 . This is a "CHAMPUS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 110706 . This is a "MHN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 116574 . This is a "BEHAVIORAL HEALTH NETWORK" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 392986 . This is a "MVP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 093500000 . This is a "MAGELLAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 21723 . This is a "NATIONAL REGISTER" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: P01808 . This is a "NYSPA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 0033013 . This is a "VALUE OPTIONS--EMPIRE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 01555215 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 10048886 . This is a "CDPHP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1443-4363 . This is a "APA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 87726 . This is a "UNITED BEHAVIORAL HEALTH" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: S04903-1B . This is a "WORKER'S COMP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 61-24393 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 72416 . This is a "UPSTATE ADMINISTRATIVE SERVICES" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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