Healthcare Provider Details

I. General information

NPI: 1528070695
Provider Name (Legal Business Name): CARMEN PEREZ APN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/13/2006
Last Update Date: 03/26/2025
Certification Date: 03/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

137 ATLANTIC CITY BLVD
BEACHWOOD NJ
08722-2935
US

IV. Provider business mailing address

137 ATLANTIC CITY BLVD
BEACHWOOD NJ
08722-2935
US

V. Phone/Fax

Practice location:
  • Phone: 732-244-8666
  • Fax: 732-244-0046
Mailing address:
  • Phone: 732-244-8666
  • Fax: 732-244-0046

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number26NJ00017800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: