Awilda Perez - Lane, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

013880 Issued in NJ

Practice address

156 W 56TH St Ste 1804
New York, NY 10019-3878

Phone

(212) 851-8100

Fax

(212) 537-0102

NPI assigned

Jul 5, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626825600000",
    "number": "1326079088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 MAIN ST APT 126",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076015743",
            "telephone_number": "201-315-8140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "156 W 56TH ST STE 1804",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100193878",
            "telephone_number": "212-851-8100",
            "fax_number": "212-537-0102"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "240 Main St Apt 126",
            "address_purpose": "LOCATION",
            "city": "Hackensack",
            "state": "NJ",
            "postal_code": "076015743",
            "country_code": "US",
            "telephone_number": "201-315-8140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEREZ - LANE",
        "first_name": "AWILDA",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-05",
        "last_updated": "2021-07-21",
        "certification_date": "2021-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "NJ",
            "license": "35SI100429700",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "013880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "013880",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yelena Perevozkina, M.S. CCC-SLP
• Elene Lucia Pereyra
• Fanney Pereyra
• Ninnet Mariela Pereyra
• Patricia Pereyra
• Bianca Perez Alvarado, FNP
• Alvaro Perez Daisson
• Claudia D Perez Gomez
• Cynthia Veronica Perez Gonzalez
• Jaime Yamil Perez Lizardi, MD

• Clinical Psychologist in New York, NY
• Providers in New York, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2021; 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.