Basic Information
| Provider Information | |||||||||
| NPI: | 1861477192 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CORDA | ||||||||
| FirstName: | PETER | ||||||||
| MiddleName: | DENNIS | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 8890 | ||||||||
| Address2: | |||||||||
| City: | TURNERSVILLE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080120453 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8567404888 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2007 N BLACK HORSE PIKE | ||||||||
| Address2: | |||||||||
| City: | WILLIAMSTOWN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080949120 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8567404888 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/09/2005 | ||||||||
| LastUpdateDate: | 02/26/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/26/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 25MB04459800 | NJ | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.