NPI 1740719814
Jerricson Barlis Peralta, IDC
Practice location
- Address
- 402 Goodrich Avenue, Kittery, ME 03904
- Phone
- (207) 438-1781
- Mailing address
- 6850 Mission Gorge Rd APT 1248, San Diego, CA 92120-2478
Registered specialties
Independent Duty Corpsman
Primary
Registry record
- NPI
- 1740719814
- Entity type
- Individual
- Sex (as registered)
- Male
- NPI issued
- 12 Jun 2017
- Record last updated
- 27 Jan 2025
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.