MEDICARE: MR. EURY 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	172A00000X	Driver

General Provider Information

NPI Number	:	1902260342
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. EURY PEREZ

Provider Business Mailing Address
First Line	:	1700 JEROME AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10453-5704
Country	:	US
Telephone Number	:	718-561-0441
Fax Number	:	347-862-4222

Provider Business Practice Location Address
First Line	:	1700 JEROME AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10453-5704
Country	:	US
Telephone Number	:	718-561-0441
Fax Number	:	347-862-4222

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

Provider Enumeration Date	:	04/12/2016
Last Update Date	:	04/12/2016

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Directions to “ MR. EURY PEREZ ” Practice Location

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