MEDICARE: LINETTE NAVARRO-PEREZ

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	174400000X	Specialist	168019071	NY
2	174400000X	Specialist	164100071	NY

General Provider Information

NPI Number	:	1407224371
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINETTE NAVARRO-PEREZ

Provider Business Mailing Address
First Line	:	1429 LOMBARDY BLVD
Second Line	:
City	:	BAY SHORE
State	:	NY
Zip	:	11706-4045
Country	:	US
Telephone Number	:	347-866-2652
Fax Number	:

Provider Business Practice Location Address
First Line	:	1429 LOMBARDY BLVD
Second Line	:
City	:	BAY SHORE
State	:	NY
Zip	:	11706-4045
Country	:	US
Telephone Number	:	347-866-2652
Fax Number	:

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

Provider Enumeration Date	:	09/09/2015
Last Update Date	:	09/09/2015

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Directions to “ LINETTE NAVARRO-PEREZ ” Practice Location

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