MEDICARE: DR. JAMES PEREZ

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	207R00000X	Internal Medicine Physician	25MA04302500	NJ

General Provider Information

NPI Number	:	1770546301
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES PEREZ

Provider Business Mailing Address
First Line	:	824 ELIZABETH AVE
Second Line	:
City	:	ELIZABETH
State	:	NJ
Zip	:	07201-4708
Country	:	US
Telephone Number	:	908-352-9556
Fax Number	:	908-352-9134

Provider Business Practice Location Address
First Line	:	824 ELIZABETH AVE
Second Line	:
City	:	ELIZABETH
State	:	NJ
Zip	:	07201-2709
Country	:	US
Telephone Number	:	908-352-9556
Fax Number	:	908-352-9134

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

Provider Enumeration Date	:	04/06/2006
Last Update Date	:	12/15/2017

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