1326152166 NPI number — DR. PETER WRIGHT III MD

Table of content: DR. PETER WRIGHT III MD (NPI 1326152166)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326152166 NPI number — DR. PETER WRIGHT III MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WRIGHT
Provider First Name:
PETER
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
III
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WRIGHT
Provider Other First Name:
PETER
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
IX
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1326152166
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/26/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
19 BAKER AVE
Provider Second Line Business Mailing Address:
STE 302
Provider Business Mailing Address City Name:
POUGHKEEPSIE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
12601
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
845-483-5888
Provider Business Mailing Address Fax Number:
845-471-4381

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
19 BAKER AVE
Provider Second Line Business Practice Location Address:
STE 302
Provider Business Practice Location Address City Name:
POUGHKEEPSIE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-483-5888
Provider Business Practice Location Address Fax Number:
845-471-4381
Provider Enumeration Date:
08/18/2006

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: 207V00000X , with the licence number:  138741 , 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: 00432682 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




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