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NPI Code Detail

MEDICARE: DYLAN MATTHEW PEREZ PT, DPT

MEDICARE: DYLAN MATTHEW PEREZ PT, DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist40QA02406100NJ

General Provider Information

NPI Number : 1790631091
Entity Type Code : Individual
Provider Name (Legal Business Name) : DYLAN MATTHEW PEREZ PT, DPT
Provider Business Mailing Address
First Line : 1455 BROAD ST STE 250
Second Line :
City : BLOOMFIELD
State : NJ
Zip : 07003-3066
Country : US
Telephone Number : 877-532-7837
Fax Number :
Provider Business Practice Location Address
First Line : 1455 BROAD ST STE 250
Second Line :
City : BLOOMFIELD
State : NJ
Zip : 07003-3066
Country : US
Telephone Number : 201-431-0534
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2026
Last Update Date : 03/09/2026

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