Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 280479 | NY |
N | 2080P0203X | Pediatric Critical Care Doctor | PENDING | NY |
NPI | 1003233487 |
---|---|
Provider Name | Michelle Maria Perez |
First Address | Paramus, NJ 07652-3218 |
Second Address | Paramus, NJ 07652-3218 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2014 |
Last Update Date | 21/02/2020 |