Provider Demographics
NPI:1124421672
Name:ALLEVA, PERRY CARMEN
Entity type:Individual
Prefix:MR
First Name:PERRY
Middle Name:CARMEN
Last Name:ALLEVA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:433 CATHARINE ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19147-3105
Mailing Address - Country:US
Mailing Address - Phone:267-679-2959
Mailing Address - Fax:215-592-6517
Practice Address - Street 1:433 CATHARINE ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19147-3105
Practice Address - Country:US
Practice Address - Phone:267-679-2959
Practice Address - Fax:215-592-6517
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-29
Last Update Date:2014-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA251E0000X251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health