Individual
AUGUSTINE PEREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OPHTHALMIC DISPENSER
Contact information
Practice address
235 PROSPECT AVE, WEST ORANGE, NJ 07052-4228
(973) 736-0553
(073) 736-6496
Mailing address
235 PROSPECT AVE, WEST ORANGE, NJ 07052-4228
(973) 736-0553
(073) 736-6496
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
D2147
NJ
Other
Enumeration date
03/26/2007
Last updated
07/08/2007
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