Provider Demographics
NPI:1639432404
Name:PEREZ-SALCE, THELMA M
Entity Type:Individual
Prefix:MS
First Name:THELMA
Middle Name:M
Last Name:PEREZ-SALCE
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 1:40 MEADOWS ST
Mailing Address - Street 2:
Mailing Address - City:PEARL RIVER
Mailing Address - State:NY
Mailing Address - Zip Code:10965-1912
Mailing Address - Country:US
Mailing Address - Phone:917-478-1235
Mailing Address - Fax:845-620-0346
Practice Address - Street 1:40 MEADOWS ST
Practice Address - Street 2:
Practice Address - City:PEARL RIVER
Practice Address - State:NY
Practice Address - Zip Code:10965-1912
Practice Address - Country:US
Practice Address - Phone:917-478-1235
Practice Address - Fax:845-620-0346
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-18
Last Update Date:2012-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist