MEDICARE: MRS. FRANCISCA MERCEDES PEREZ LCSW-R

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	071154-1	NY

General Provider Information

NPI Number	:	1073676284
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. FRANCISCA MERCEDES PEREZ LCSW-R

Provider Business Mailing Address
First Line	:	1151 TUXEDO SQ
Second Line	:
City	:	TEANECK
State	:	NJ
Zip	:	07666-5830
Country	:	US
Telephone Number	:	201-833-9411
Fax Number	:

Provider Business Practice Location Address
First Line	:	1151 TUXEDO SQ
Second Line	:	260 EAST 188TH STREET BRONX, NEW YORK
City	:	TEANECK
State	:	NJ
Zip	:	07666-5830
Country	:	US
Telephone Number	:	201-833-9411
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/18/2006
Last Update Date	:	07/08/2007

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