Provider Demographics
NPI:1306926993
Name:ELIZABETH P DEPERIO M D AND ASSOCIATES P C
Entity type:Organization
Organization Name:ELIZABETH P DEPERIO M D AND ASSOCIATES P C
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH PINKY
Authorized Official - Middle Name:
Authorized Official - Last Name:DE PERIO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-901-7786
Mailing Address - Street 1:4677 US HIGHWAY 9
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07731-3384
Mailing Address - Country:US
Mailing Address - Phone:732-901-7786
Mailing Address - Fax:732-901-4080
Practice Address - Street 1:4677 US HIGHWAY 9
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:NJ
Practice Address - Zip Code:07731-3384
Practice Address - Country:US
Practice Address - Phone:732-901-7786
Practice Address - Fax:732-901-4080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ014889Medicare ID - Type Unspecified