Provider Demographics
NPI:1902479058
Name:PAEZ, WILLIAM MANUEL (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:MANUEL
Last Name:PAEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:WILLIAM
Other - Middle Name:MANUEL
Other - Last Name:PAEZ LUNA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:465 SOUTH ST STE 103
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-6442
Mailing Address - Country:US
Mailing Address - Phone:973-695-4726
Mailing Address - Fax:973-290-7495
Practice Address - Street 1:435 SOUTH ST STE 350
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-6474
Practice Address - Country:US
Practice Address - Phone:973-971-6700
Practice Address - Fax:973-290-7480
Is Sole Proprietor?:No
Enumeration Date:2021-07-16
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA12219000207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine