Provider Demographics
NPI:1023284791
Name:PERE, AYSE (NP)
Entity type:Individual
Prefix:
First Name:AYSE
Middle Name:
Last Name:PERE
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 1:117 MARYS AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401-5849
Mailing Address - Country:US
Mailing Address - Phone:845-331-8146
Mailing Address - Fax:845-331-3314
Practice Address - Street 1:117 MARYS AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-5849
Practice Address - Country:US
Practice Address - Phone:845-331-8146
Practice Address - Fax:845-331-3314
Is Sole Proprietor?:No
Enumeration Date:2008-05-02
Last Update Date:2010-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY334885363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner