Provider Demographics
NPI:1760361356
Name:PEREZ, CAROLINE STEPHANIE
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:STEPHANIE
Last Name:PEREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:771 GROTE ST APT 5
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10460-1069
Mailing Address - Country:US
Mailing Address - Phone:646-972-3448
Mailing Address - Fax:646-972-3448
Practice Address - Street 1:771 GROTE ST APT 5
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10460-1069
Practice Address - Country:US
Practice Address - Phone:646-972-3448
Practice Address - Fax:646-972-3448
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-28
Last Update Date:2025-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator