Basic Information
Provider Information
NPI: 1467058099
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PEREZ
FirstName: RITA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 100 MADISON AVE
Address2:  
City: MORRISTOWN
State: NJ
PostalCode: 079606136
CountryCode: US
TelephoneNumber: 9739715000
FaxNumber:  
Practice Location
Address1: 100 MADISON AVE
Address2:  
City: MORRISTOWN
State: NJ
PostalCode: 079606136
CountryCode: US
TelephoneNumber: 9739715000
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/09/2020
LastUpdateDate: 12/09/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/09/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LC0200X26NJ01067700NJY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine

No ID Information.


Home