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NPI Code Detail

MEDICARE: MR. ANTHONY PEREZ LCSW MSW R

MEDICARE: MR. ANTHONY PEREZ LCSW MSW R
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
11041C0700XClinical Social WorkerR28804NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
17323442OTHEROXFORD
21030790OTHERBEACON
354317000OTHERMAGEUAN

General Provider Information

NPI Number : 1952473944
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ANTHONY PEREZ LCSW MSW R
Provider Business Mailing Address
First Line : 53 MORTON ST
Second Line :
City : GARNERVILLE
State : NY
Zip : 10923-1428
Country : US
Telephone Number : 845-947-1357
Fax Number :
Provider Business Practice Location Address
First Line : 53 MORTON ST
Second Line :
City : GARNERVILLE
State : NY
Zip : 10923-1428
Country : US
Telephone Number : 845-947-1357
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/14/2006
Last Update Date : 07/08/2007

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