Provider Demographics
NPI:1407224371
Name:NAVARRO-PEREZ, LINETTE
Entity type:Individual
Prefix:
First Name:LINETTE
Middle Name:
Last Name:NAVARRO-PEREZ
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 1:1429 LOMBARDY BLVD
Mailing Address - Street 2:
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-4045
Mailing Address - Country:US
Mailing Address - Phone:347-866-2652
Mailing Address - Fax:
Practice Address - Street 1:1429 LOMBARDY BLVD
Practice Address - Street 2:
Practice Address - City:BAY SHORE
Practice Address - State:NY
Practice Address - Zip Code:11706-4045
Practice Address - Country:US
Practice Address - Phone:347-866-2652
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-09
Last Update Date:2015-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY168019071174400000X
NY164100071174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist