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NPI Code Detail

MEDICARE: MARK J. PERRY MSW

MEDICARE: MARK J. PERRY MSW
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
1172V00000XCommunity Health Worker

General Provider Information

NPI Number : 1477316933
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARK J. PERRY MSW
Provider Business Mailing Address
First Line : PO BOX 647
Second Line :
City : MONTPELIER
State : VT
Zip : 05601-0647
Country : US
Telephone Number : 802-301-3200
Fax Number : 802-223-0842
Provider Business Practice Location Address
First Line : 34 BARRE ST
Second Line :
City : MONTPELIER
State : VT
Zip : 05602-3510
Country : US
Telephone Number : 802-301-3200
Fax Number : 802-223-0842
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2024
Last Update Date : 02/06/2024

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