Healthcare Provider Details

I. General information

NPI: 1700706124
Provider Name (Legal Business Name): JULIA PEREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 LOMBARD ST
NEW HAVEN CT
06513-2910
US

IV. Provider business mailing address

501 LOMBARD ST
NEW HAVEN CT
06513-2910
US

V. Phone/Fax

Practice location:
  • Phone: 203-874-6270
  • Fax:
Mailing address:
  • Phone: 203-874-6270
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number12423
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: