Provider Demographics
NPI:1780392357
Name:PEREZ, CHRISTOPHER AYENTO (PT,DPT, WCC)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:AYENTO
Last Name:PEREZ
Suffix:
Gender:M
Credentials:PT,DPT, WCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6994 ROCKFIELD RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21244-8022
Mailing Address - Country:US
Mailing Address - Phone:443-929-5410
Mailing Address - Fax:
Practice Address - Street 1:2434 W BELVEDERE AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-5267
Practice Address - Country:US
Practice Address - Phone:410-601-2256
Practice Address - Fax:410-601-2928
Is Sole Proprietor?:No
Enumeration Date:2022-11-11
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD22683225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist