Provider Demographics
NPI:1871041582
Name:PEREZ, CATALINA A (RN, RNC-MNN-IBCLC)
Entity Type:Individual
Prefix:MS
First Name:CATALINA
Middle Name:A
Last Name:PEREZ
Suffix:
Gender:F
Credentials:RN, RNC-MNN-IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 E 129TH ST
Mailing Address - Street 2:#2B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10035-1109
Mailing Address - Country:US
Mailing Address - Phone:415-640-0874
Mailing Address - Fax:
Practice Address - Street 1:54 E 129TH ST
Practice Address - Street 2:#2B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10035-1109
Practice Address - Country:US
Practice Address - Phone:415-640-0874
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-12
Last Update Date:2016-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA500122163W00000X
NY22 623969163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
No163W00000XNursing Service ProvidersRegistered Nurse