Provider Demographics
NPI:1952934705
Name:PEREZLOPEZ, MONICA G
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:G
Last Name:PEREZLOPEZ
Suffix:
Gender:F
Credentials:
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 1349
Mailing Address - Street 2:
Mailing Address - City:MONTAGUE
Mailing Address - State:NJ
Mailing Address - Zip Code:07827-0349
Mailing Address - Country:US
Mailing Address - Phone:973-997-9276
Mailing Address - Fax:
Practice Address - Street 1:358 ROLLING RIDGE ROAD
Practice Address - Street 2:
Practice Address - City:MONTAGUE
Practice Address - State:NJ
Practice Address - Zip Code:07827
Practice Address - Country:US
Practice Address - Phone:973-997-9276
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-20
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider