Provider Demographics
NPI:1063475697
Name:PEREZ, ALFREDO J (MD)
Entity Type:Individual
Prefix:
First Name:ALFREDO
Middle Name:J
Last Name:PEREZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HOOKSETT PRIMARY CARE
Mailing Address - Street 2:11 KIMBALL DRIVE
Mailing Address - City:HOOKSETT
Mailing Address - State:NH
Mailing Address - Zip Code:03106
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:HOOKSETT PRIMARY CARE
Practice Address - Street 2:11 KIMBALL DRIVE
Practice Address - City:HOOKSETT
Practice Address - State:NH
Practice Address - Zip Code:03106
Practice Address - Country:US
Practice Address - Phone:603-663-1990
Practice Address - Fax:603-663-1989
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH13555207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHI00771Medicare UPIN