Most Relevant Information
Provider Data
| NPI Number: | 1003077405 |
| Provider Name: | PETER C FAN AUDIOLOGIST (AUD) |
| Entity Type: | Individual |
| Taxonomy Code: | 231H00000X |
| Specialty: | Audiologist |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/19/2008 |
| Last Updated: | 10/31/2022 |
Provider Practice Location
200 PERRINE RD STE 210
OLD BRIDGE
NJ
088572836
Practice Location Phone/Fax
| Phone: | 9143335801 |
| Fax: |
Provider Mailing Location
200 PERRINE RD STE 210
OLD BRIDGE
NJ
088572836
Provider Mailing Phone/Fax
| Phone: | 9143335801 |
| Fax: |