Provider Demographics
NPI:1669464541
Name:VERIDIANO, NORMA PEREZ (MD)
Entity Type:Individual
Prefix:DR
First Name:NORMA
Middle Name:PEREZ
Last Name:VERIDIANO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2183 OCEAN AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-2303
Mailing Address - Country:US
Mailing Address - Phone:718-382-6565
Mailing Address - Fax:718-382-6658
Practice Address - Street 1:2183 OCEAN AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-2303
Practice Address - Country:US
Practice Address - Phone:718-382-6565
Practice Address - Fax:718-382-6658
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY115489207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00213194Medicaid
NY00213194Medicaid
NYC12538Medicare UPIN