Thomas R Peterson MD PC

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

MA5194 Issued in NJ

Legal business name

THOMAS R PETERSON MD PC

Practice address

140 Prospect Ave
Suite 18
Hackensack, NJ 07600

Phone

(201) 525-0500

Fax

(201) 525-1171

NPI assigned

Sep 25, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Thomas R Peterson, MD

Title

President

Phone

(201) 525-0500

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1164522629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 PROSPECT AVE",
            "address_2": "SUITE 18",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "07600",
            "telephone_number": "201-525-0500",
            "fax_number": "201-525-1171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 PROSPECT AVE",
            "address_2": "SUITE 18",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "07600",
            "telephone_number": "201-525-0500",
            "fax_number": "201-525-1171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS R PETERSON MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-525-0500",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": "NJ",
            "license": "MA5194",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0154105",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Neurological Surgery Physician in Hackensack, NJ
• Providers in Hackensack, NJ by specialty
• Neurological Surgery Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.