Provider Demographics
NPI:1285967984
Name:PEREZ, ABNER (CRNA)
Entity type:Individual
Prefix:MR
First Name:ABNER
Middle Name:
Last Name:PEREZ
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 WOODS RD
Mailing Address - Street 2:
Mailing Address - City:VALHALLA
Mailing Address - State:NY
Mailing Address - Zip Code:10595-1530
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:95 GRASSLANDS RD
Practice Address - Street 2:MACY PAVILION RM #2359
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595-1652
Practice Address - Country:US
Practice Address - Phone:914-493-7857
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-12
Last Update Date:2009-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY391640367500000X
NY391640-1163W00000X
NJ26NR1255040163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse