Provider Demographics
NPI:1689106767
Name:BETSY PEREZ UROLOGY PLLC
Entity Type:Organization
Organization Name:BETSY PEREZ UROLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:Z
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:802-888-8823
Mailing Address - Street 1:51 BRIGHAM ST
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:VT
Mailing Address - Zip Code:05661-6031
Mailing Address - Country:US
Mailing Address - Phone:802-888-8823
Mailing Address - Fax:802-888-8825
Practice Address - Street 1:51 BRIGHAM ST
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:VT
Practice Address - Zip Code:05661-6031
Practice Address - Country:US
Practice Address - Phone:802-888-8823
Practice Address - Fax:802-888-8825
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-29
Last Update Date:2019-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty