Provider Demographics
NPI:1457619983
Name:PEREIRA, ELIZABETH (RN)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:PEREIRA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:413 EAST 120TH STREET, 2ND / 3RD FLOOR
Mailing Address - Street 2:HARLEM MULTI-SERVICE CENTER - DOHMH OSH
Mailing Address - City:MANHATTAN
Mailing Address - State:NY
Mailing Address - Zip Code:10035-3602
Mailing Address - Country:US
Mailing Address - Phone:917-492-6950
Mailing Address - Fax:917-492-6972
Practice Address - Street 1:413 EAST 120TH STREET, 2ND / 3RD FLOOR
Practice Address - Street 2:HARLEM MULTI-SERVICE CENTER - DOHMH OSH
Practice Address - City:MANHATTAN
Practice Address - State:NY
Practice Address - Zip Code:10035-3602
Practice Address - Country:US
Practice Address - Phone:917-492-6950
Practice Address - Fax:917-492-6972
Is Sole Proprietor?:No
Enumeration Date:2012-05-03
Last Update Date:2012-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY351264163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool