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NPI Code Detail

MEDICARE: RICHARD PERIUT MD LLC

MEDICARE: RICHARD PERIUT MD LLC
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
1174400000XSpecialistMA68984NJ

General Provider Information

NPI Number : 1801842208
Entity Type Code : Organization
Provider Name (Legal Business Name) : RICHARD PERIUT MD LLC
Provider Business Mailing Address
First Line : 44 FRANKLIN ST
Second Line :
City : LITTLE FERRY
State : NJ
Zip : 07643-1218
Country : US
Telephone Number : 201-512-9494
Fax Number :
Provider Business Practice Location Address
First Line : 3701 PARK AVE
Second Line :
City : UNION CITY
State : NJ
Zip : 07087-6021
Country : US
Telephone Number : 201-440-2222
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. RICHARD PERIUT
Credential : MD
Telephone Number : 201-440-2222
Provider Enumeration Date : 05/26/2006
Last Update Date : 07/27/2011

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