Individual provider Active NPI

Rosario Perez, MSED

  • Specialist
  • College Point, NY
National Provider Identifier
1962764670
Registry record updated Jun 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
644221051 Issued in NY
Practice address
12116 Powells Cove Blvd Apt B
College Point, NY 11356-1259
Phone
(917) 670-7445
NPI assigned
Jun 10, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 644221051 NY Primary

Addresses

Primary practice location

12116 Powells Cove Blvd Apt B
College Point, NY 11356-1259

Mailing address

12116 Powells Cove Blvd Apt B
College Point, NY 11356-1259
Phone (917) 670-7445

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

State licenses

LicenseStateTypeSpecialty
644221051NYMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1339286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339286400000",
    "number": "1962764670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12116 POWELLS COVE BLVD APT B",
            "city": "COLLEGE POINT",
            "state": "NY",
            "postal_code": "113561259",
            "telephone_number": "917-670-7445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12116 POWELLS COVE BLVD APT B",
            "city": "COLLEGE POINT",
            "state": "NY",
            "postal_code": "113561259",
            "telephone_number": "917-670-7445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "ROSARIO",
        "credential": "MSED",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-10",
        "last_updated": "2012-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "644221051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in College Point, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2012; 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.