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General NPI Number Information
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NPI Number | 1679350599
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Entity Type | Individual
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Provider Name | PAYEL MERIUM PERIS DMD
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Gender | Female
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Dates
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Enumeration Date | 09/13/2023
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Last Update Date | 09/13/2023
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Provider Practice Location Address
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Address Line | 1 ROBERT WOOD JOHNSON PL STE D
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City | NEW BRUNSWICK
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State | NJ
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Zip | 08901-1928
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Country | US
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Telephone | 732-937-8653
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Fax |
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Provider Business Mailing Address
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Address Line | 238 JEWETT AVE
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City | JERSEY CITY
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State | NJ
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Zip | 07304-1804
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Country | US
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Telephone | 201-688-9295
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 22DR03852
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License Number State | NJ
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