Provider Demographics
NPI:1831487446
Name:PEREZ-COSTE, MARIA (MD)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:PEREZ-COSTE
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 1:710 W 168TH ST
Mailing Address - Street 2:TRUSTEES OF COLUMBIA UNIVERSITNEUROLOGICAL INSTITUTE 12
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-3726
Mailing Address - Country:US
Mailing Address - Phone:212-932-4165
Mailing Address - Fax:
Practice Address - Street 1:541 BROADWAY
Practice Address - Street 2:ALLEN PAVILLION
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012-3944
Practice Address - Country:US
Practice Address - Phone:212-932-4165
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-16
Last Update Date:2014-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2740702084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry