Perez, Raul Iluminado

Perez, Raul Iluminado is an individual health care provider with primary practice located at 605 S Broad St Unit B , Elizabeth NJ 07202-2601. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Perez, Raul Iluminado can be contacted via phone (908) 659-0075.

Contact Information

Primary practice address
605 S Broad St Unit B Elizabeth NJ 07202-2601
Phone: (908) 659-0075
Fax: (908) 469-4300
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 16896 Puerto Rico
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 25MA08784100 New Jersey

Profile Details

NPI number 1003081076
LBN Legal business name Perez, Raul Iluminado
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 29th, 2008
Last updated Feb 19th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003081076 NPPES
New Jersey MEDICAID 0253651

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