Provider Demographics
NPI:1073200200
Name:PEREZ, OLIVIA D (MD)
Entity type:Individual
Prefix:DR
First Name:OLIVIA
Middle Name:D
Last Name:PEREZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:227 E 30TH ST # 703C
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-8203
Mailing Address - Country:US
Mailing Address - Phone:929-237-9190
Mailing Address - Fax:
Practice Address - Street 1:227 E 30TH ST # 703C
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-8203
Practice Address - Country:US
Practice Address - Phone:929-237-9190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-19
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY333512208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice