MEDICARE: MR. ALFRED JAMES PERUGINI JR.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	28RI01344500	NJ

General Provider Information

NPI Number	:	1467055863
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ALFRED JAMES PERUGINI JR.

Provider Business Mailing Address
First Line	:	50 CHESTNUT WAY CIR
Second Line	:
City	:	BARNEGAT
State	:	NJ
Zip	:	08005-2060
Country	:	US
Telephone Number	:	609-713-6639
Fax Number	:

Provider Business Practice Location Address
First Line	:	353 ROUTE 37 E
Second Line	:
City	:	TOMS RIVER
State	:	NJ
Zip	:	08753-5562
Country	:	US
Telephone Number	:	732-341-3622
Fax Number	:	732-341-4863

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/18/2020
Last Update Date	:	11/18/2020

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