Active NPI
John Perez
- School Psychologist
- Cornwall, NY
National Provider Identifier
1245574524
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 021754
- Practice address
- 20 Frost LN
Cornwall, NY 12518-1306 - Phone
- (646) 209-9949
- NPI assigned
- Nov 26, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 021754 | NY | Primary |
Addresses
Primary practice location
20 Frost LN
Cornwall, NY 12518-1306
Mailing address
20 Frost LN
Cornwall, NY 12518-1306
Phone (646) 209-9949
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1353888000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1471392000000",
"number": "1245574524",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 FROST LN",
"city": "CORNWALL",
"state": "NY",
"postal_code": "125181306",
"telephone_number": "646-209-9949"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 FROST LN",
"city": "CORNWALL",
"state": "NY",
"postal_code": "125181306",
"telephone_number": "646-209-9949"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEREZ",
"first_name": "JOHN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-11-26",
"last_updated": "2016-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "NY",
"license": "021754",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cornwall, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.