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General NPI Number Information
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NPI Number | 1467414128
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Entity Type | Organization
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Legal Business Name | WALTER PEREZ, M.D., L.L.C.
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Dates
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Enumeration Date | 04/06/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 213 HARRISON AVE
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City | HARRISON
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State | NJ
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Zip | 07029-1340
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Country | US
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Telephone | 973-350-0800
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Fax | 973-350-0885
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Provider Business Mailing Address
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Address Line | PO BOX 213
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City | HARRISON
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State | NJ
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Zip | 07029-0213
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Country | US
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Telephone | 973-350-0800
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Fax | 973-350-0885
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | INES PEREZ
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Credential |
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Telephone | 973-868-6597
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State | NJ
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