Provider Demographics
NPI:1659175875
Name:PEREZ, SULEY (LSW)
Entity type:Individual
Prefix:
First Name:SULEY
Middle Name:
Last Name:PEREZ
Suffix:
Gender:
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:564 52ND ST APT 206
Mailing Address - Street 2:
Mailing Address - City:WEST NEW YORK
Mailing Address - State:NJ
Mailing Address - Zip Code:07093-5647
Mailing Address - Country:US
Mailing Address - Phone:201-238-7876
Mailing Address - Fax:201-238-7876
Practice Address - Street 1:346 CLAREMONT AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07305-1634
Practice Address - Country:US
Practice Address - Phone:201-915-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-04
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06979900104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty