Evangeline Perez DO PC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

222603 Issued in NY

Legal business name

EVANGELINE PEREZ DO PC

Doing business as

Bay Ridge Dermatology

Practice address

515 84TH St
1St FL
Brooklyn, NY 11209-4701

Phone

(347) 497-4984

Fax

(347) 497-4980

NPI assigned

Jun 9, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Evangeline Perez, DONPI 1891761334

Title

President

Phone

(347) 497-4984

Specialties & licenses 1

Addresses

Other names 1

• Bay Ridge Dermatology Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Evangeline Perez, DO

  • Dermatology Physician
  • Brooklyn, NY
  • NPI 1891761334
  Medicare reassignment NPD Authorized official
• Kerry Ly, PA-C

  • Physician Assistant
  • Brooklyn, NY
  • NPI 1275304248

  Single Specialty

  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1212969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212969600000",
    "number": "1053570556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 84TH ST",
            "address_2": "1ST FL",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112094701",
            "telephone_number": "347-497-4984",
            "fax_number": "347-497-4980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 84TH ST",
            "address_2": "1ST FL",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112094701",
            "telephone_number": "347-497-4984",
            "fax_number": "347-497-4980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVANGELINE PEREZ DO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-09",
        "last_updated": "2008-06-09",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "EVANGELINE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "347-497-4984",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "NY",
            "license": "222603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bay Ridge Dermatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sheikh M Eusuf, D.D.S
• Ev Physical Therapy and Acupuncture, PLLC
• Eva Medical PC
• Evalcare Inc.
• Christina Evaldi, LMSW
• Vaughan Diane Evanier, LCSW
• Evans Dental Practice P.C.
• Evans Drug Store,Inc
• Marcelina Evans- Smith
• Clarista Evans-Boyd, RN

• Dermatology Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Dermatology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.