Portillo Diaz, Ernesto Rafael

Portillo Diaz, Ernesto Rafael is an individual health care provider with primary practice located at 530 New Brunswick Ave , Perth Amboy NJ 08861-3654. He recently has only one registered license in Student, Health Care / Student in an Organized Health Care Education/Training Program, which is considered as his primary health care specialty. Portillo Diaz, Ernesto Rafael can be contacted via phone (732) 324-5080.

Contact Information

Primary practice address
530 New Brunswick Ave Perth Amboy NJ 08861-3654
Phone: (732) 324-5080
Fax: (732) 324-4669
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X

Profile Details

NPI number 1700479078
LBN Legal business name Portillo Diaz, Ernesto Rafael
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 17th, 2021
Last updated Feb 17th, 2021 - about 3 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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