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General NPI Number Information
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NPI Number | 1275467987
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Entity Type | Individual
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Provider Name | EVAN ANTHONY PERONE
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Gender | Male
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Dates
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Enumeration Date | 06/09/2026
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Last Update Date | 06/09/2026
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Provider Practice Location Address
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Address Line | 526 WOOD ST
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City | BETHLEHEM
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State | PA
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Zip | 18018-4453
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Country | US
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Telephone | 610-625-4885
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Fax |
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Provider Business Mailing Address
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Address Line | 3 WEBSTER ST
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City | EAST BANGOR
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State | PA
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Zip | 18013-2147
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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 |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | TOP009441
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License Number State | PA
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