Provider Demographics
NPI:1245006832
Name:PEREZ, ULYSSES
Entity type:Individual
Prefix:MR
First Name:ULYSSES
Middle Name:
Last Name:PEREZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 N 3RD ST UNIT 304
Mailing Address - Street 2:
Mailing Address - City:STEUBENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43952-0113
Mailing Address - Country:US
Mailing Address - Phone:323-500-8818
Mailing Address - Fax:
Practice Address - Street 1:1324 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:STEUBENVILLE
Practice Address - State:OH
Practice Address - Zip Code:43952-1569
Practice Address - Country:US
Practice Address - Phone:929-403-2780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide