Individual
DR. RAUL ILUMINADO PEREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
605 S BROAD ST UNIT B, ELIZABETH, NJ 07202-2601
(908) 659-0075
(908) 469-4300
Mailing address
605 S BROAD ST UNIT B, ELIZABETH, NJ 07202-2601
(908) 659-0075
(908) 469-4300
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
16896
PR
207Q00000X
Family Medicine Physician
Primary
25MA08784100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0253651
—
NJ
Enumeration date
04/29/2008
Last updated
02/19/2011
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