Provider Demographics
NPI:1821343286
Name:HEIGHTS MEDICAL CONSULTANTS PA
Entity Type:Organization
Organization Name:HEIGHTS MEDICAL CONSULTANTS PA
Other - Org Name:JOSEPH R. PEREA, MD
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:RUBEN
Authorized Official - Last Name:PEREA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:505-883-7525
Mailing Address - Street 1:4300 SAN MATEO BLVD NE
Mailing Address - Street 2:SUITE B270
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-1229
Mailing Address - Country:US
Mailing Address - Phone:505-883-7525
Mailing Address - Fax:505-883-7535
Practice Address - Street 1:4300 SAN MATEO BLVD NE
Practice Address - Street 2:SUITE B270
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-1229
Practice Address - Country:US
Practice Address - Phone:505-883-7525
Practice Address - Fax:505-883-7535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-20
Last Update Date:2012-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMNM8079261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM00045146Medicaid
D35881Medicare UPIN