Provider Demographics
NPI:1326303694
Name:PEREZ-PADILLA, STEVE ANTHONY (SP ED THERAPIST)
Entity Type:Individual
Prefix:MR
First Name:STEVE
Middle Name:ANTHONY
Last Name:PEREZ-PADILLA
Suffix:
Gender:M
Credentials:SP ED THERAPIST
Other - Prefix:MR
Other - First Name:STEVE
Other - Middle Name:ANTHONY
Other - Last Name:PEREZ-PADILLA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:SP, ED THERAPIST
Mailing Address - Street 1:3052 KINGSBRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-5113
Mailing Address - Country:US
Mailing Address - Phone:347-601-6455
Mailing Address - Fax:
Practice Address - Street 1:3636 33RD ST
Practice Address - Street 2:SUITE 500
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11106-2329
Practice Address - Country:US
Practice Address - Phone:212-529-9780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-11
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY137216021171WH0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications