Provider Demographics
NPI:1447211131
Name:WOHL, PETER EVAN (DC)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:EVAN
Last Name:WOHL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 S KINDERKAMACK RD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:MONTVALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07645-2168
Mailing Address - Country:US
Mailing Address - Phone:201-746-6577
Mailing Address - Fax:201-746-6576
Practice Address - Street 1:2 S KINDERKAMACK RD
Practice Address - Street 2:SUITE 208
Practice Address - City:MONTVALE
Practice Address - State:NJ
Practice Address - Zip Code:07645-2168
Practice Address - Country:US
Practice Address - Phone:201-746-6577
Practice Address - Fax:201-746-6576
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00624500111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VOO391Medicare UPIN
080741Medicare ID - Type Unspecified