Provider Demographics
NPI:1295887123
Name:PERINE, BETTY ANN (RN CNM NP)
Entity type:Individual
Prefix:
First Name:BETTY
Middle Name:ANN
Last Name:PERINE
Suffix:
Gender:F
Credentials:RN CNM NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5445 FIELDSTON ROAD
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10471
Mailing Address - Country:US
Mailing Address - Phone:347-427-1036
Mailing Address - Fax:347-427-1036
Practice Address - Street 1:1111 AMSTERDAM AVENUE
Practice Address - Street 2:ST LUKES ROOSEVELT HOSPITAL CLARK 2 OB GYN
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025
Practice Address - Country:US
Practice Address - Phone:212-523-3720
Practice Address - Fax:212-523-1723
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3457381163W00000X
NYF4204821363LW0102X
NYF0004851367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Not Answered367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife