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General NPI Number Information
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NPI Number | 1942791728
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Entity Type | Individual
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Provider Name | CARLOS R PEREZ MD
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Gender | Male
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Dates
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Enumeration Date | 05/28/2018
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Last Update Date | 04/26/2022
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Provider Practice Location Address
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Address Line | 534 21ST AVE
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City | PATERSON
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State | NJ
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Zip | 07513-1337
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Country | US
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Telephone | 973-925-5400
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Fax | 972-925-5403
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Provider Business Mailing Address
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Address Line | 534 21ST AVE
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City | PATERSON
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State | NJ
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Zip | 07513-1337
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Country | US
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Telephone | 973-925-5400
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Fax | 972-925-5403
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 25MA11022200
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License Number State | NJ
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