Provider Demographics
NPI:1972862381
Name:PEREZ, TERESITA VERZOSA (NP)
Entity Type:Individual
Prefix:
First Name:TERESITA
Middle Name:VERZOSA
Last Name:PEREZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2235 5TH AVE
Mailing Address - Street 2:APARTMENT 5A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10037-2114
Mailing Address - Country:US
Mailing Address - Phone:347-820-1918
Mailing Address - Fax:212-860-7416
Practice Address - Street 1:2235 5TH AVENUE
Practice Address - Street 2:APARTMENT 5A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10037-2116
Practice Address - Country:US
Practice Address - Phone:347-820-1918
Practice Address - Fax:212-860-7416
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-07
Last Update Date:2015-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF430617-1163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine