MS. KIMBERLY J PERDOMO AGPCNP-BC NPI 1861068827

NPI Information

NPI: 1861068827
Provider Name: MS. KIMBERLY J PERDOMO, AGPCNP-BC
Classification: Nurse Practitioner - 363LP2300X
Entity Type: Individual

Specialization: Primary Care

Organization: EXCELCARE MEDICAL ASSOCIATES PA

PECOS Registration: Yes

Address:
92 SUMMIT AVE
HACKENSACK, NJ
ZIP 07601
Phone: (201) 342-0066
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MS. Kimberly J Perdomo, AGPCNP-BC is a primary care nurse practitioner in Hackensack, NJ with 4 years of experience. MS. Kimberly J Perdomo, AGPCNP-BC NPI is 1861068827. The provider is registered as an individual entity type and is a single specialty group.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

92 SUMMIT AVE
HACKENSACK, NJ
ZIP 07601-263
Phone: (201) 342-0066

The NPI 1861068827 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/1/2021 and was last updated on 8/9/2021.

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	363LP2300X	Nurse Practitioner	Primary Care	26NJ01163000	NEW JERSEY	Yes
2	207R00000X	Internal Medicine		26NJ01163000	NEW JERSEY	No

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: 11/14/2023

NPI Synchronization or Removal

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