Provider Demographics
NPI:1710179825
Name:PERRON, THOMAS WEST (NP)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:WEST
Last Name:PERRON
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:424 W 34TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-2321
Mailing Address - Country:US
Mailing Address - Phone:212-695-3444
Mailing Address - Fax:212-695-0242
Practice Address - Street 1:424 W 34TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-2321
Practice Address - Country:US
Practice Address - Phone:212-695-3444
Practice Address - Fax:212-695-0242
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-13
Last Update Date:2007-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY401078363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health