Provider Demographics
NPI:1245758572
Name:PERALTA, ANEL M (RN)
Entity Type:Individual
Prefix:MS
First Name:ANEL
Middle Name:M
Last Name:PERALTA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 RIVERSIDE DR APT 4H
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-7370
Mailing Address - Country:US
Mailing Address - Phone:646-363-4896
Mailing Address - Fax:
Practice Address - Street 1:801 RIVERSIDE DR APT 4H
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-7370
Practice Address - Country:US
Practice Address - Phone:646-363-4896
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-07
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7388661163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse