Provider Demographics
NPI:1588686737
Name:PEREZ, MARIA (MD)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:PEREZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6300 POWERS RD
Mailing Address - Street 2:
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-3216
Mailing Address - Country:US
Mailing Address - Phone:716-667-3222
Mailing Address - Fax:716-667-3213
Practice Address - Street 1:6300 POWERS RD
Practice Address - Street 2:
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-3216
Practice Address - Country:US
Practice Address - Phone:716-667-3222
Practice Address - Fax:716-667-3213
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2007-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY192720207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY040426001438OtherFIDELIS
NY0406665OtherINDEPENDENT HEALTH
NY000523533002OtherBLUE CROSS OF WNY
NY00010196801OtherUNIVERA
NY000523533002OtherBLUE CROSS OF WNY
NY040426001438OtherFIDELIS