Healthcare Provider Details

I. General information

NPI: 1780949792
Provider Name (Legal Business Name): DENIA M. PEREZ APN-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2012
Last Update Date: 04/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32 HINE ST STE 103
PATERSON NJ
07503-2955
US

IV. Provider business mailing address

707 SALEM ST
TEANECK NJ
07666-5319
US

V. Phone/Fax

Practice location:
  • Phone: 973-341-3782
  • Fax: 973-341-3783
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number26NJ00373800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: