Healthcare Provider Details

I. General information

NPI: 1972862381
Provider Name (Legal Business Name): TERESITA VERZOSA PEREZ N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/07/2012
Last Update Date: 07/28/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2235 5TH AVENUE APARTMENT 5A
NEW YORK NY
10037-2116
US

IV. Provider business mailing address

2235 5TH AVE APARTMENT 5A
NEW YORK NY
10037-2114
US

V. Phone/Fax

Practice location:
  • Phone: 347-820-1918
  • Fax: 212-860-7416
Mailing address:
  • Phone: 347-820-1918
  • Fax: 212-860-7416

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberF430617-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: