Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 26NJ00017800 | NJ |
NPI | 1528070695 |
---|---|
Provider Name | Carmen Perez |
First Address | Toms River, NJ 08755-1375 |
Second Address | Toms River, NJ 08755-1375 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2006 |
Last Update Date | 23/02/2017 |