Provider Demographics
NPI:1982094405
Name:PERES, CHARMAINE (CNA)
Entity type:Individual
Prefix:
First Name:CHARMAINE
Middle Name:
Last Name:PERES
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 E 96TH ST APT B8
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11212-3757
Mailing Address - Country:US
Mailing Address - Phone:347-824-6740
Mailing Address - Fax:
Practice Address - Street 1:14 E 96TH ST APT B8
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11212-3757
Practice Address - Country:US
Practice Address - Phone:347-824-6740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-04
Last Update Date:2015-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY343560230514E376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide