Individual provider Active NPI

Lori Perez, PH.D.

  • Clinical Psychologist
  • Brooklyn, NY
National Provider Identifier
1245706555
Registry record updated Oct 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
022257-1 Issued in NY
Practice address
3512 Quentin Rd Ste 110
Brooklyn, NY 11234-4245
Phone
(800) 275-3243
NPI assigned
Oct 15, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 022257-1 NY Primary

Addresses

Primary practice location

3512 Quentin Rd Ste 110
Brooklyn, NY 11234-4245

Mailing address

7 Beatrice CV
Fairport, NY 14450-3154

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
022257-1NYMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1539561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539561600000",
    "number": "1245706555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 BEATRICE CV",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144503154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3512 QUENTIN RD STE 110",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112344245",
            "telephone_number": "800-275-3243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "LORI",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-15",
        "last_updated": "2018-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "022257-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.