Provider Demographics
NPI:1396280814
Name:PEREZ, FELIX EDUARDO (PT)
Entity type:Individual
Prefix:
First Name:FELIX
Middle Name:EDUARDO
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 1:704 HILLSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:CLIFFSIDE PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07010-2010
Mailing Address - Country:US
Mailing Address - Phone:323-810-7244
Mailing Address - Fax:
Practice Address - Street 1:704 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:CLIFFSIDE PARK
Practice Address - State:NJ
Practice Address - Zip Code:07010-2010
Practice Address - Country:US
Practice Address - Phone:323-810-7244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-20
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA292534225100000X
NJ40QA01848600225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist