Provider Demographics
NPI:1518333277
Name:PEREZ, BIANY (MED, MSS, LSW)
Entity Type:Individual
Prefix:
First Name:BIANY
Middle Name:
Last Name:PEREZ
Suffix:
Gender:F
Credentials:MED, MSS, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1429 WALNUT ST
Mailing Address - Street 2:SUITE NUMBER 1300
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-3218
Mailing Address - Country:US
Mailing Address - Phone:215-563-7863
Mailing Address - Fax:
Practice Address - Street 1:1429 WALNUT ST
Practice Address - Street 2:SUITE NUMBER 1300
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-3218
Practice Address - Country:US
Practice Address - Phone:215-563-7863
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-18
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW132666104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker