Provider Demographics
NPI:1992305650
Name:PEREZ, NOE ALEJANDRO
Entity type:Individual
Prefix:
First Name:NOE
Middle Name:ALEJANDRO
Last Name:PEREZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6661 SANNS DR
Mailing Address - Street 2:
Mailing Address - City:LESAGE
Mailing Address - State:WV
Mailing Address - Zip Code:25537-9784
Mailing Address - Country:US
Mailing Address - Phone:304-620-2007
Mailing Address - Fax:
Practice Address - Street 1:6661 SANNS DR
Practice Address - Street 2:
Practice Address - City:LESAGE
Practice Address - State:WV
Practice Address - Zip Code:25537-9784
Practice Address - Country:US
Practice Address - Phone:304-620-2007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-30
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant