Provider Demographics
NPI:1821891698
Name:SIERUTA, PERLA MAITEE
Entity type:Individual
Prefix:MRS
First Name:PERLA
Middle Name:MAITEE
Last Name:SIERUTA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 WALLINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:WALLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07057-1339
Mailing Address - Country:US
Mailing Address - Phone:201-364-1508
Mailing Address - Fax:
Practice Address - Street 1:240 WALLINGTON AVE
Practice Address - Street 2:
Practice Address - City:WALLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07057-1339
Practice Address - Country:US
Practice Address - Phone:201-364-1508
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-28
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter