Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | MD058902L | PA |
NPI | 1063477487 |
---|---|
Provider Name | Dr. Carlos R. Perez |
First Address | Danville, PA 17822-3034 |
Second Address | Danville, PA 17822-1339 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2006 |
Last Update Date | 02/11/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001587846 | (05) | PA |
E07730 | (02) |