Provider Demographics
NPI:1477399384
Name:JEREMY PERES, PHD, PSYD, LLC
Entity type:Organization
Organization Name:JEREMY PERES, PHD, PSYD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:
Authorized Official - Last Name:PERES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-714-3682
Mailing Address - Street 1:3715 GARRETT RD # 1064
Mailing Address - Street 2:
Mailing Address - City:DREXEL HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19026-3040
Mailing Address - Country:US
Mailing Address - Phone:267-714-3682
Mailing Address - Fax:
Practice Address - Street 1:3715 GARRETT RD # 1064
Practice Address - Street 2:
Practice Address - City:DREXEL HILL
Practice Address - State:PA
Practice Address - Zip Code:19026-3040
Practice Address - Country:US
Practice Address - Phone:267-714-3682
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-02
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty