Provider Demographics
NPI:1275919706
Name:PEREZ, ANA IRIS
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:IRIS
Last Name:PEREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:198 GREENGROVE AVE
Mailing Address - Street 2:
Mailing Address - City:UNIONDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11553-1118
Mailing Address - Country:US
Mailing Address - Phone:646-641-9762
Mailing Address - Fax:
Practice Address - Street 1:198 GREENGROVE AVE
Practice Address - Street 2:
Practice Address - City:UNIONDALE
Practice Address - State:NY
Practice Address - Zip Code:11553-1118
Practice Address - Country:US
Practice Address - Phone:646-641-9762
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-06
Last Update Date:2015-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist