Perez, Raul Iluminado
Perez, Raul Iluminado is an individual health care provider with primary practice located at 605 S Broad St Unit B , Elizabeth NJ 07202-2601. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Perez, Raul Iluminado can be contacted via phone (908) 659-0075.Contact Information
Primary practice address
605 S Broad St Unit B
Elizabeth NJ 07202-2601
Phone: (908) 659-0075
Fax: (908) 469-4300
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 16896 | Puerto Rico |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 25MA08784100 | New Jersey |
Profile Details
| NPI number | 1003081076 |
|---|---|
| LBN Legal business name | Perez, Raul Iluminado |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 29th, 2008 |
| Last updated | Feb 19th, 2011 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1003081076 | NPPES |
| New Jersey | MEDICAID | 0253651 |
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