Provider Demographics
NPI:1366828683
Name:PEREZ, AARON (PT, DPT, CSCS)
Entity Type:Individual
Prefix:DR
First Name:AARON
Middle Name:
Last Name:PEREZ
Suffix:
Gender:M
Credentials:PT, DPT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 ROOSEVELT AVE
Mailing Address - Street 2:APT 7
Mailing Address - City:HORSEHEADS
Mailing Address - State:NY
Mailing Address - Zip Code:14845-8222
Mailing Address - Country:US
Mailing Address - Phone:773-344-4271
Mailing Address - Fax:
Practice Address - Street 1:133 N MAIN ST
Practice Address - Street 2:
Practice Address - City:HORSEHEADS
Practice Address - State:NY
Practice Address - Zip Code:14845-2175
Practice Address - Country:US
Practice Address - Phone:607-739-1700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-10
Last Update Date:2015-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY039075225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist