Provider Demographics
NPI:1124274816
Name:PEREIRA, EUGENE FRANCIS (MT)
Entity type:Individual
Prefix:MR
First Name:EUGENE
Middle Name:FRANCIS
Last Name:PEREIRA
Suffix:
Gender:M
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:15 MOHEGAN AVE
Mailing Address - Street 2:USCGA MEDICAL
Mailing Address - City:NEW LONDON
Mailing Address - State:CT
Mailing Address - Zip Code:06320-4195
Mailing Address - Country:US
Mailing Address - Phone:860-701-6904
Mailing Address - Fax:860-444-8413
Practice Address - Street 1:15 MOHEGAN AVE
Practice Address - Street 2:USCGA MEDICAL
Practice Address - City:NEW LONDON
Practice Address - State:CT
Practice Address - Zip Code:06320-4195
Practice Address - Country:US
Practice Address - Phone:860-701-6904
Practice Address - Fax:860-444-8413
Is Sole Proprietor?:No
Enumeration Date:2008-08-13
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
146627246QM0706X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246QM0706XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyMedical Technologist