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General NPI Number Information
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NPI Number | 1114595592
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Entity Type | Organization
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Legal Business Name | PERRY MEDICAL GROUP OF NEW JERSEY PA
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Dates
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Enumeration Date | 06/14/2021
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Last Update Date | 01/24/2023
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Provider Practice Location Address
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Address Line | 150 W 22ND ST FL 8
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City | NEW YORK
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State | NY
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Zip | 10011-6557
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Country | US
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Telephone | 646-809-4094
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Fax |
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Provider Business Mailing Address
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Address Line | 1 SANSOME ST ST 3500
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City | SAN FRANCISCO
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State | CA
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Zip | 94104-4448
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR, RCM
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Name | PHAT NGUYEN
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Credential |
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Telephone | 206-412-4766
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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