MEDICARE: IRIS JANET PEREZ VASQUEZ

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	101YM0800X	Mental Health Counselor		NY

General Provider Information

NPI Number	:	1881557403
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IRIS JANET PEREZ VASQUEZ

Provider Business Mailing Address
First Line	:	8732 16TH AVE FL 2
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11214-4526
Country	:	US
Telephone Number	:	917-847-9788
Fax Number	:

Provider Business Practice Location Address
First Line	:	2037 UTICA AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-3234
Country	:	US
Telephone Number	:	718-262-8190
Fax Number	:

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

Provider Enumeration Date	:	12/09/2025
Last Update Date	:	12/09/2025

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