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NPI Code Detail

MEDICARE: NATHANAEL PERRIZO MSC

MEDICARE:   NATHANAEL  PERRIZO  MSC
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
1101Y00000XCounselorLAC-16066AZ

General Provider Information

NPI Number : 1871941963
Entity Type Code : Individual
Provider Name (Legal Business Name) : NATHANAEL PERRIZO MSC
Provider Business Mailing Address
First Line : 8847 E POSADA AVE
Second Line :
City : MESA
State : AZ
Zip : 85212-2842
Country : US
Telephone Number : 480-290-2533
Fax Number :
Provider Business Practice Location Address
First Line : 2563 S VAL VISTA DR
Second Line : SE CORNER OF VAL VISTA AND WILLIAMS FIELD
City : GILBERT
State : AZ
Zip : 85295-1804
Country : US
Telephone Number : 480-290-2533
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/30/2016
Last Update Date : 05/30/2016

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Directions to “ NATHANAEL PERRIZO MSC” Practice Location

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