Provider Demographics
NPI:1669417721
Name:PEREIRA, GILBERTO R (MD)
Entity type:Individual
Prefix:DR
First Name:GILBERTO
Middle Name:R
Last Name:PEREIRA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5129 PAIST RD
Mailing Address - Street 2:
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18902-1860
Mailing Address - Country:US
Mailing Address - Phone:267-544-0332
Mailing Address - Fax:267-544-0332
Practice Address - Street 1:5129 PAIST RD
Practice Address - Street 2:CHILDREN'S HOSPITAL OF PHILADELPHIA
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18902-1860
Practice Address - Country:US
Practice Address - Phone:267-544-0332
Practice Address - Fax:267-544-0332
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-20
Last Update Date:2013-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA067897L208000000X, 2080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0006619580001Medicaid
NJ3735702Medicaid
NJ3735702Medicaid
PA0006619580001Medicaid