Mario Perez, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

015531 Issued in CT

Practice address

100 Jefferson SQ
Waterbury, CT 06706-1109

Phone

(203) 709-6200

Fax

(203) 709-3335

NPI assigned

Jun 28, 2006

Last updated

Sep 12, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189555200000",
    "number": "1700814076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56 FRANKLIN ST",
            "address_2": "3RD FLOOR",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067061221",
            "telephone_number": "203-709-8873",
            "fax_number": "203-709-8689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 JEFFERSON SQ",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067061109",
            "telephone_number": "203-709-6200",
            "fax_number": "203-709-3335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "MARIO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2007-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "015531",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001155317",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Giselle Perez
• Jasmine Perez, LMT
• Josephine Perez
• Kenny Perez
• Marie Perez, LPC
• Meagan N Perez
• Performance Foot & Ankle Specialists, LLC
• Nicole Taylor Perin, DPT
• Katrina Perkins
• Raizel Perl

• Psychiatry Physician in Waterbury, CT
• Providers in Waterbury, CT by specialty
• Psychiatry Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2007; 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.