Provider Demographics
NPI:1194526814
Name:PEREZ, LINET
Entity type:Individual
Prefix:
First Name:LINET
Middle Name:
Last Name:PEREZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 STUYVESANT AVE
Mailing Address - Street 2:
Mailing Address - City:LYNDHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:07071-1017
Mailing Address - Country:US
Mailing Address - Phone:786-717-0407
Mailing Address - Fax:
Practice Address - Street 1:16 STUYVESANT AVE
Practice Address - Street 2:
Practice Address - City:LYNDHURST
Practice Address - State:NJ
Practice Address - Zip Code:07071-1017
Practice Address - Country:US
Practice Address - Phone:786-717-0407
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-19
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist