Healthcare Provider Details

I. General information

NPI: 1962311886
Provider Name (Legal Business Name): YEIMI SOSA PEREZ CPED5003
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/06/2026
Certification Date: 09/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1410 KINGS HWY N
CHERRY HILL NJ
08034-2305
US

IV. Provider business mailing address

1410 KINGS HWY N
CHERRY HILL NJ
08034-2305
US

V. Phone/Fax

Practice location:
  • Phone: 856-412-0827
  • Fax:
Mailing address:
  • Phone: 856-412-0827
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224L00000X
TaxonomyPedorthist
License Number
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: