Provider Demographics
NPI:1902260342
Name:PEREZ, EURY
Entity Type:Individual
Prefix:MR
First Name:EURY
Middle Name:
Last Name:PEREZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 JEROME AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10453-5704
Mailing Address - Country:US
Mailing Address - Phone:718-561-0441
Mailing Address - Fax:347-862-4222
Practice Address - Street 1:1700 JEROME AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10453-5704
Practice Address - Country:US
Practice Address - Phone:718-561-0441
Practice Address - Fax:347-862-4222
Is Sole Proprietor?:No
Enumeration Date:2016-04-12
Last Update Date:2016-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver