Healthcare Provider Details

I. General information

NPI: 1619437944
Provider Name (Legal Business Name): MANUEL PEREIRA HERRERA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2019
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1610 ROUTE 88 FL 3
BRICK NJ
08724-3018
US

IV. Provider business mailing address

331 NEWMAN SPRINGS ROAD BLDG. 2, SUITE 220
RED BANK NJ
07701
US

V. Phone/Fax

Practice location:
  • Phone: 732-295-6543
  • Fax: 732-295-6204
Mailing address:
  • Phone: 732-807-0877
  • Fax: 201-751-1680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number25MA11521300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: