Individual
DIANDRA PEREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
750 E ADAMS ST, SYRACUSE, NY 13210-2306
(315) 464-7117
Mailing address
8301 CRIMSON KING CIR, BALDWINSVILLE, NY 13027-8937
(305) 903-1658
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
315045
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/17/2017
Last updated
06/29/2022
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