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NPI Code Detail

MEDICARE: ANDREA THERESE PERAU

MEDICARE:   ANDREA THERESE PERAU
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
1174400000XSpecialistNY

General Provider Information

NPI Number : 1386596831
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREA THERESE PERAU
Provider Business Mailing Address
First Line : 42 HAMMOCK LN
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10312-1617
Country : US
Telephone Number : 347-737-9816
Fax Number :
Provider Business Practice Location Address
First Line : 1854 HYLAN BLVD
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10305-2119
Country : US
Telephone Number : 347-737-9816
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/09/2026
Last Update Date : 02/09/2026

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Directions to “ ANDREA THERESE PERAU ” Practice Location

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