Perez, Mario
Perez, Mario is an individual health care provider with primary practice located at 100 Jefferson Sq , Waterbury CT 06706-1109. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Perez, Mario can be contacted via phone (203) 709-6200.Contact Information
Primary practice address
100 Jefferson Sq
Waterbury CT 06706-1109
Phone: (203) 709-6200
Fax: (203) 709-3335
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 015531 | Connecticut |
Profile Details
| NPI number | 1700814076 |
|---|---|
| LBN Legal business name | Perez, Mario |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 28th, 2006 |
| Last updated | Sep 12th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1700814076 | NPPES |
| Connecticut | MEDICAID | 001155317 |
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