Provider Demographics
NPI:1518500016
Name:JOSE E PERAZA MD PLLC
Entity Type:Organization
Organization Name:JOSE E PERAZA MD PLLC
Other - Org Name:PERAZA DERMATOLOGY GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PERAZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-542-6455
Mailing Address - Street 1:252 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:NH
Mailing Address - Zip Code:03743-2636
Mailing Address - Country:US
Mailing Address - Phone:603-542-6455
Mailing Address - Fax:603-543-0736
Practice Address - Street 1:252 BROAD ST
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:NH
Practice Address - Zip Code:03743-2636
Practice Address - Country:US
Practice Address - Phone:603-542-6455
Practice Address - Fax:603-543-0736
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-28
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty