ERNESTO RAFAEL PORTILLO DIAZ MD NPI 1700479078

NPI Information

NPI: 1700479078
Provider Name: ERNESTO RAFAEL PORTILLO DIAZ, MD
Classification: Student in an Organized Health Care Education/Training Program - 390200000X
Entity Type: Individual
Address:
530 NEW BRUNSWICK AVE
PERTH AMBOY, NJ
ZIP 08861
Phone: (732) 324-5080
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Ernesto Rafael Portillo Diaz, MD is a student in an organized health care education training program in Perth Amboy, NJ. The provider is an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. Ernesto Rafael Portillo Diaz, MD NPI is 1700479078. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

530 NEW BRUNSWICK AVE
PERTH AMBOY, NJ
ZIP 08861-654
Phone: (732) 324-5080
Fax: (732) 324-4669

The enumeration date for this NPI number is 2/17/2021 and was last updated on 2/17/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	390200000X	Student in an Organized Health Care Education/Training Program				Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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