Provider Demographics
NPI:1386468882
Name:ALCANTARA, PERLA ESTHER
Entity type:Individual
Prefix:MRS
First Name:PERLA
Middle Name:ESTHER
Last Name:ALCANTARA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 104
Mailing Address - Street 2:
Mailing Address - City:CALLICOON
Mailing Address - State:NY
Mailing Address - Zip Code:12723-0104
Mailing Address - Country:US
Mailing Address - Phone:833-344-5439
Mailing Address - Fax:833-344-5439
Practice Address - Street 1:32 LOWER MAIN ST UNIT 1
Practice Address - Street 2:
Practice Address - City:CALLICOON
Practice Address - State:NY
Practice Address - Zip Code:12723-5001
Practice Address - Country:US
Practice Address - Phone:833-344-5439
Practice Address - Fax:833-344-5439
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-12
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator