MEDICARE: DR. MANUEL GARCIA PEREZ MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	113690	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	12 01134	OTHER		UNITED HEALTHCARE
2	0082663	OTHER	NY	GHI
3	2C5916	OTHER	NY	HEALTH NET
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	113690	OTHER		HIP
6	0501228	OTHER		US HEALTHCARE
7	4564361	OTHER		AETNA PPO
8	MP20 00884	OTHER		METROPLUS
9	207466	OTHER		WELLCARE
10	113690 A19	OTHER		HEALTH FIRST

General Provider Information

NPI Number	:	1043200827
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MANUEL GARCIA PEREZ MD

Provider Business Mailing Address
First Line	:	183 MAMARONECK RD
Second Line	:
City	:	SCARSDALE
State	:	NY
Zip	:	10583-4527
Country	:	US
Telephone Number	:	914-723-8779
Fax Number	:

Provider Business Practice Location Address
First Line	:	531 E 138TH ST
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10454-3087
Country	:	US
Telephone Number	:	718-993-5959
Fax Number	:	718-993-5959

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/24/2005
Last Update Date	:	07/08/2007

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