Provider Demographics
NPI:1962658450
Name:PEREZ, IRIS (FNP)
Entity Type:Individual
Prefix:
First Name:IRIS
Middle Name:
Last Name:PEREZ
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 597
Mailing Address - Street 2:
Mailing Address - City:BRIDGETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08302-0433
Mailing Address - Country:US
Mailing Address - Phone:856-451-4700
Mailing Address - Fax:856-794-7183
Practice Address - Street 1:1038 E CHESTNUT AVE
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-5800
Practice Address - Country:US
Practice Address - Phone:856-691-3300
Practice Address - Fax:856-794-7183
Is Sole Proprietor?:No
Enumeration Date:2008-08-15
Last Update Date:2008-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN03219300207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine