Provider Demographics
NPI:1821117847
Name:PEREZ, MATTHEW KURT (MD, PHD)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:KURT
Last Name:PEREZ
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9701 VENTNOR AVE
Mailing Address - Street 2:
Mailing Address - City:MARGATE CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:08402-2222
Mailing Address - Country:US
Mailing Address - Phone:609-399-6102
Mailing Address - Fax:609-399-4424
Practice Address - Street 1:9701 VENTNOR AVE
Practice Address - Street 2:
Practice Address - City:MARGATE CITY
Practice Address - State:NJ
Practice Address - Zip Code:08402-2222
Practice Address - Country:US
Practice Address - Phone:609-822-4242
Practice Address - Fax:609-822-3211
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2018-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT181695207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ112029DS4Medicare PIN
NJP00437370Medicare PIN