Provider Demographics
NPI:1285722603
Name:PEREZ, VINCENT (PT)
Entity type:Individual
Prefix:
First Name:VINCENT
Middle Name:
Last Name:PEREZ
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 W CROOKED HILL RD
Mailing Address - Street 2:
Mailing Address - City:PEARL RIVER
Mailing Address - State:NY
Mailing Address - Zip Code:10965-1016
Mailing Address - Country:US
Mailing Address - Phone:845-548-3145
Mailing Address - Fax:845-517-1431
Practice Address - Street 1:37 W JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:PEARL RIVER
Practice Address - State:NY
Practice Address - Zip Code:10965-2217
Practice Address - Country:US
Practice Address - Phone:845-548-3145
Practice Address - Fax:845-517-1431
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2011-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist