Basic Information
| Provider Information | |||||||||
| NPI: | 1023037512 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PECK | ||||||||
| FirstName: | ALEXANDER | ||||||||
| MiddleName: | S. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 111 FOUNDERS PLZ | ||||||||
| Address2: | #300 C/O IPMS | ||||||||
| City: | EAST HARTFORD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 061083212 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8602824137 | ||||||||
| FaxNumber: | 8602820170 | ||||||||
| Practice Location | |||||||||
| Address1: | 111 FOUNDERS PLZ | ||||||||
| Address2: | #300 C/O IPMS | ||||||||
| City: | EAST HARTFORD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 061083212 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8602824137 | ||||||||
| FaxNumber: | 8602820170 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/18/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 014017 | CT | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.