Healthcare Provider Details

I. General information

NPI: 1700061637
Provider Name (Legal Business Name): MARIA GORETTI ACUNA PEREZ C.N.M
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2008
Last Update Date: 01/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 GUSTAVE L LEVY PL # 1153 MT SINAI HOSPITAL
NEW YORK NY
10029-6500
US

IV. Provider business mailing address

190 E 7TH ST APT 103
NEW YORK NY
10009-5976
US

V. Phone/Fax

Practice location:
  • Phone: 212-241-6228
  • Fax:
Mailing address:
  • Phone: 917-291-9377
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number001299-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: