Provider Demographics
NPI:1467055863
Name:PERUGINI, ALFRED JAMES JR
Entity Type:Individual
Prefix:MR
First Name:ALFRED
Middle Name:JAMES
Last Name:PERUGINI
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 CHESTNUT WAY CIR
Mailing Address - Street 2:
Mailing Address - City:BARNEGAT
Mailing Address - State:NJ
Mailing Address - Zip Code:08005-2060
Mailing Address - Country:US
Mailing Address - Phone:609-713-6639
Mailing Address - Fax:
Practice Address - Street 1:353 ROUTE 37 E
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-5562
Practice Address - Country:US
Practice Address - Phone:732-341-3622
Practice Address - Fax:732-341-4863
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-18
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI01344500183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist