Provider Demographics
NPI:1477500114
Name:PIJEM BERRIOS, JOAN EILEEN (MD)
Entity Type:Individual
Prefix:DR
First Name:JOAN
Middle Name:EILEEN
Last Name:PIJEM BERRIOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JOAN
Other - Middle Name:EILEEN
Other - Last Name:PIJEM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1967 CALLE NOGAL
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-4728
Mailing Address - Country:US
Mailing Address - Phone:787-664-3816
Mailing Address - Fax:620-506-4381
Practice Address - Street 1:126 AVE DE DIEGO
Practice Address - Street 2:SEIN MEDICAL PLAZA SUITE 3
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921-3141
Practice Address - Country:US
Practice Address - Phone:787-664-3816
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-28
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME87498174400000X
PR15883207Q00000X, 207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
No174400000XOther Service ProvidersSpecialist
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU3261YMedicare ID - Type Unspecified
FLI15344Medicare UPIN