Provider Demographics
NPI:1598348732
Name:NEGRON-PEREZ, WILMA
Entity Type:Individual
Prefix:
First Name:WILMA
Middle Name:
Last Name:NEGRON-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 1:2215 NOTT ST APT 1
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12309-4338
Mailing Address - Country:US
Mailing Address - Phone:518-930-6139
Mailing Address - Fax:
Practice Address - Street 1:526 ALTAMONT AVE
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12303-1039
Practice Address - Country:US
Practice Address - Phone:518-217-5458
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-05
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY333282164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse