Provider Demographics
NPI:1801207410
Name:PEREIRA, MARIA NATASHA LUZY
Entity Type:Individual
Prefix:MRS
First Name:MARIA NATASHA
Middle Name:LUZY
Last Name:PEREIRA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARIA NATASHA
Other - Middle Name:LUZY
Other - Last Name:ALPHONSO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:130 PONDFIELD RD
Mailing Address - Street 2:# 1
Mailing Address - City:BRONXVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10708
Mailing Address - Country:US
Mailing Address - Phone:914-337-3253
Mailing Address - Fax:914-337-7013
Practice Address - Street 1:130 PONDFIELD RD
Practice Address - Street 2:# 1
Practice Address - City:BRONXVILLE
Practice Address - State:NY
Practice Address - Zip Code:10708
Practice Address - Country:US
Practice Address - Phone:914-337-3253
Practice Address - Fax:914-337-7013
Is Sole Proprietor?:No
Enumeration Date:2014-05-16
Last Update Date:2014-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006063.101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor