Individual provider Active NPI

Damian Edward Peters, PHARMD

  • Pharmacist
  • Hoboken, NJ
National Provider Identifier
1225470545
Registry record updated Jul 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
28RI02761000 Issued in NJ
Practice address
604 Park Ave
Hoboken, NJ 07030-3908
Phone
(732) 266-2090
Fax
(888) 495-9659
NPI assigned
Jul 28, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28RI02761000 NJ Primary

Addresses

Primary practice location

604 Park Ave
Hoboken, NJ 07030-3908

Mailing address

604 Park Ave
Hoboken, NJ 07030-3908
Phone (732) 266-2090

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
28RI02761000NJMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1374969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374969600000",
    "number": "1225470545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 PARK AVE",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "070303908",
            "telephone_number": "732-266-2090",
            "fax_number": "888-495-9659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 PARK AVE",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "070303908",
            "telephone_number": "732-266-2090",
            "fax_number": "888-495-9659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "DAMIAN",
        "middle_name": "EDWARD",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-07-28",
        "last_updated": "2013-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI02761000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hoboken, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2013; 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.