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General NPI Number Information
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NPI Number | 1053178822
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Entity Type | Organization
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Legal Business Name | EXTERIOR MEDICAL
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Dates
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Enumeration Date | 02/28/2024
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Last Update Date | 02/29/2024
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Provider Practice Location Address
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Address Line | 628 W 238TH ST
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City | BRONX
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State | NY
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Zip | 10463-1464
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Country | US
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Telephone | 917-692-3143
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Fax |
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Provider Business Mailing Address
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Address Line | 3226 OXFORD AVE
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City | BRONX
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State | NY
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Zip | 10463-3589
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/MEDICAL DIRECTOR
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Name | LUISA PEREZ
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Credential | MD
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Telephone | 917-692-3143
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number |
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License Number State |
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