Provider Demographics
NPI:1033138540
Name:DE PERIO, ELIZABETH PINKY PAMINTUAN (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH PINKY
Middle Name:PAMINTUAN
Last Name:DE PERIO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4677 US HIGHWAY 9
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07731-3384
Mailing Address - Country:US
Mailing Address - Phone:732-901-7786
Mailing Address - Fax:732-901-4080
Practice Address - Street 1:4677 US HIGHWAY 9
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:NJ
Practice Address - Zip Code:07731-3384
Practice Address - Country:US
Practice Address - Phone:732-901-7786
Practice Address - Fax:732-901-4080
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA06079900207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJG01520Medicare UPIN
NJ711085Medicare ID - Type Unspecified