Provider Demographics
NPI:1114595592
Name:PERRY MEDICAL GROUP OF NEW JERSEY PA
Entity Type:Organization
Organization Name:PERRY MEDICAL GROUP OF NEW JERSEY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, RCM
Authorized Official - Prefix:
Authorized Official - First Name:PHAT
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-412-4766
Mailing Address - Street 1:1 SANSOME ST
Mailing Address - Street 2:ST 3500
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94104-4448
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:150 W 22ND ST FL 8
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-6557
Practice Address - Country:US
Practice Address - Phone:646-809-4094
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-14
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty