Healthcare Provider Details

I. General information

NPI: 1801238092
Provider Name (Legal Business Name): CLARIBEL PEREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2013
Last Update Date: 08/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 TILDEN ST
BRONX NY
10467-6013
US

IV. Provider business mailing address

963 ANDERSON AVE
BRONX NY
10452-5627
US

V. Phone/Fax

Practice location:
  • Phone: 718-231-3400
  • Fax:
Mailing address:
  • Phone: 646-401-6376
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number084256
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: